Steroids and Cross-Linking for Ulcer Treatment

Do adjunctive topical corticosteroids with or without corneal cross-linking improve outcomes in bacterial keratitis?In this randomized clinical trial including 280 participants, no difference was found in 6-month visual acuity or rate of corneal perforation and/or need for therapeutic penetrating keratoplasty with adjunctive topical steroid or cross-linking compared with topical antibiotic alone. Cross-linking increased scar size compared with steroid use alone.Results show that adjunctive therapies with topical corticosteroid and/or corneal cross-linking may not improve outcomes beyond topical antibiotics alone.

Corresponding Author: Jennifer R. Rose-Nussbaumer, MD, Department of Ophthalmology, Byers Eye Institute, Stanford University, 2452 Watson Ct, Palo Alto, CA 94303 (rosej@stanford.edu).

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