ReviewEye and vision (London, England)2016
PACK-CXL: Corneal cross-linking in infectious keratitis.
Review in Eye and vision (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05881187 (Analysis of the Outcomes of Photoactivated Chromophore for Keratitis Cross _linking for Treatment of Infectious Keratitis), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Analysis of the Outcomes of Photoactivated Chromophore for Keratitis Cross _linking for Treatment of Infectious Keratitis
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- Corneal cross-linking for infectious keratitis of various causes: an umbrella review.BMC ophthalmology · 2025Pooled it
- Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care.Ophthalmology and therapy · 2026Review
- Review
- Bridging gaps in corneal ulcer management: Can photoactivated chromophore for infectious keratitis-corneal collagen cross-linking delay or replace therapeutic keratoplasty?World journal of transplantation · 2026Article
- Same-session dual chromophore riboflavin/UV-A and rose bengal/green light PACK-CXL in Acanthamoeba keratitis: a case report.Eye and vision (London, England) · 2025Article
- The in vitro effect riboflavin combined with or without UVA in Acanthamoeba castellanii.Scientific reports · 2024Article
- Crosslinked All-Femtosecond Laser-Cut Corneal Allogenic Intracorneal Ring Segments (AFXL CAIRSs): Pilot Ex Vivo Study and Report of First Two Cases Performed in Italy.Journal of clinical medicine · 2024Article
- How does atmospheric pressure cold helium plasma affect the biomechanical behaviour on alkali-lesioned corneas?BMC veterinary research · 2024Article
- Rates of infectious keratitis and other ocular surface adverse events in corneal cross-linking for keratoconus and corneal ectasias performed in an office-based setting: a retrospective cohort study.Eye and vision (London, England) · 2023Article
- Corneal cross-linking guards against infectious keratitis: an experimental model.International ophthalmology · 2023Article
- The Antibacterial Efficacy of High-Fluence PACK Cross-Linking Can Be Accelerated.Translational vision science & technology · 2023Article
- Review
- Riboflavin/UV-A corneal phototherapy as stand-alone management of ulcerative keratitis in dogs.Veterinarni medicina · 2022Article
- Review
- Long-term outcomes of therapeutic penetrating keratoplasty for microbial keratitis in a tertiary care center in Turkey.International ophthalmology · 2020Article
- Enzymatic Digestion of Porcine Corneas Cross-linked by Hypo- and Hyperosmolar Formulations of Riboflavin/ultraviolet A or WST11/Near-Infrared Light.Translational vision science & technology · 2020Article
- Accelerated corneal collagen cross-linking in clinical management of infectious keratitis.The Journal of international medical research · 2020Article
- An Assay System to Evaluate Riboflavin/UV-A Corneal Phototherapy Efficacy in a Porcine Corneal Organ Culture Model.Animals : an open access journal from MDPI · 2020Article
- Corneal cross-linking as a treatment for corneal dystrophy with secondary bacterial infection in a Friesian horse.Clinical case reports · 2020Article
- Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking (PACK-CXL) Improves Outcomes of Treatment-Resistant Infectious Keratitis.Clinical ophthalmology (Auckland, N.Z.) · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCorneal cross-linking (CXL) using ultraviolet light-A (UV-A) and riboflavin is a technique developed in the 1990's to treat corneal ectatic disorders such as keratoconus. It soon became the new gold standard in multiple countries around the world to halt the progression of this disorder, with good long-term outcomes in keratometry reading and visual acuity. The original Dresden treatment protocol was also later on used to stabilize iatrogenic corneal ectasia appearing after laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). CXL efficiently strengthened the cornea but was also shown to kill most of the keratocytes within the corneal stroma, later on repopulated by those cells. REVIEW: Ultraviolet-light has long been known for its microbicidal effect, and thus CXL postulated to be able to sterilize the cornea from infectious pathogens. This cytotoxic effect led to the first clinical trials using CXL to treat advanced infectious melting corneal keratitis. Patients treated with this technique showed, in the majority of cases, a stabilization of the melting process and were able to avoid emergent à chaud keratoplasty. Following those primary favorable results, CXL was used to treat beginning bacterial keratitis as a first-line treatment without any adjunctive antibiotics with positive results for most patients. In order to distinguish the use of CXL for infectious keratitis treatment from its use for corneal ectatic disorders, a new term was proposed at the 9th CXL congress in Dublin to rename its use in infections as photoactivated chromophore for infectious keratitis -corneal collagen cross-linking (PACK-CXL).
conclusionPACK-CXL is now more frequently used to treat infections from various infectious origins. The original Dresden protocol is still used for this purpose. Careful modifications of this protocol could improve the efficiency of this technique in specific clinical situations regarding certain types of pathogens.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.