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2020 OMIG Abstract

Treatment of Severe Infectious Keratitis with Scleral Contact Lenses as a Reservoir of Moxifloxacin 0.5%

Eduardo J. Polania-Baron, MD, Omar Santana-Cruz, OD, Alejandro Lichtinger, MD,
Enrique O. Graue-Hernadez, MD, MSc, Alejandro Navas, MD, PhD

Department of Cornea, External Disease, and Refractive Surgery, Instituto de Oftalmología “Conde de Valenciana”, Mexico City, Mexico

Purpose: To report the outcomes of using scleral contact lenses as antibiotic reservoirs as a therapeutic approach in a case series of severe infectious keratitis, and to discuss the clinical potential.

Methods: This was a prospective consecutive case series study of 12 eyes treated for infectious keratitis at the “Conde de Valenciana” Institute of Ophthalmology. A scleral lens (SL) filled with 0.5% moxifloxacin was used as a reservoir and replaced every 24 h until epithelization was complete or the culture report and/or antibiogram demonstrated either a microorganism not susceptible to or resistant to moxifloxacin.

Results: The study included 12 eyes of 12 patients (7 women; 58.33%; average age of 63 ± 20.11 years). All patients completed at least 1 month of follow-up. Patients had a diagnosis of infectious keratitis and the SL was fitted on initial consultation. Of the 12 eyes, seven had culture-positive bacterial infection, two eyes were mycotic, and three eyes had no culture growth. In three eyes, SL was discontinued due to lack of response (one eye) or to the presence of mycotic infection (two eyes). All infections resolved favorably at final follow-up.

Conclusion: The use of scleral lenses 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 24 h wear periods.

Disclosure: N



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