Treatment of Severe Infectious Keratitis With Scleral Contac
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The use of a scleral lens could be an alternative for antibiotic impregnation and treatment of infectious keratitis. No complications or side effects were observed related to the use of the scleral contact lens as a reservoir for the antibiotic. This treatment modality could offer a comfortable treatment for the patient, ensuring good impregnation and maintenance of antibiotic concentrations during the 24-hour wear periods.

This was a prospective consecutive case series study of 12 eyes treated for infectious keratitis at the “Conde de Valenciana” Institute of Ophthalmology was conducted to report the outcomes of using scleral contact lenses as antibiotic reservoirs as a therapeutic approach in severe infectious keratitis and to discuss the clinical potential. A scleral lens (SL) filled with 0.5% moxifloxacin was used as a reservoir and replaced every 24 hours until epithelization was complete or the culture report and/or antibiogram demonstrated either a microorganism not susceptible to or resistant to moxifloxacin.

The study included 12 eyes of 12 patients. All patients completed at least 1 month of follow-up. Patients had a diagnosis of infectious keratitis, and the SL was fitted on the initial consultation. Of the 12 eyes, 7 had a culture-positive bacterial infection, 2 eyes were mycotic, and 3 eyes had no culture growth. In 3 eyes, SL was discontinued because of the lack of response (one eye) and to the presence of mycotic infection (2 eyes). All infections resolved favorably at the final follow-up.