Adjunctive Green Thermal Laser Photocoagulation for Treatment of Resistant Infectious Keratitis

PURPOSE: To investigate the safety and efficacy of green thermal laser as an adjunctive therapy for the treatment of resistant infectious keratitis (IK) in the Delta region of Egypt. METHODS: A retrospective case series of 150 patients, within a 4 year duration, with resistant IK, who failed to respond to specific medical treatment alone for 7 days, were included. They all received green thermal laser photocoagulation treatment to the cornea as an adjunctive to medical treatment. RESULTS: Forty-eight women and 102 men were included in this study with a mean age of 46.2 ± 7.7 years. Common risk factors associated with IK included trauma by material of plant origin and contact lens wear. The mean duration of healing was 2.87 ± 0.7 weeks. A single session of green thermal laser application was adequate in 138 IK cases (92%), while 12 cases (8%) required an additional session a week later. Supplementary amniotic membrane transplantation (AMT) was required in 26 cases (17.3%). Two patients (1.3%) required tectonic keratoplasty for corneal perforation. The final corrected distance visual acuity (CDVA) was counting fingers (CF) or better in 78 patients (52%). No decrease of CDVA was reported throughout the study. CONCLUSION: Green thermal laser is a safe and effective adjunctive therapy for the treatment of resistant infectious keratitis.