Successful management of refractory fungal keratitis with photoactivated chromophore for keratitis–corneal cross-linking (PACK-CXL)
Abstract
We report a case of a 44-year-old lady with recalcitrant fungal keratitis despite intensive antimicrobial therapy. Adjunctive photoactivated chromophore for keratitis–corneal cross-linking (PACK-CXL) was performed using an accelerated protocol at a fluence of 7.2 J/cm². This resulted in clinical improvement and complete re-epithelialization within three weeks. Definitive visual rehabilitation was subsequently achieved with deep anterior lamellar keratoplasty and cataract surgery, restoring the best corrected visual acuity to 6/12 at two years post-diagnosis. This case demonstrates PACK-CXL as a safe and effective adjunct in the management of refractory fungal keratitis, potentially reducing the need for high-risk therapeutic keratoplasty.
Fields of Study & Subjects
Ocular Infections and Treatments
Corneal surgery and disorders
Corneal Surgery and Treatments
Publication details
- Journal / source
- Indian Journal of Ophthalmology - Case Reports
- Volume
- 6
- Issue
- 1
- Pages
- 205–207
- Publication date
- 1 January 2026
- Language
- EN