Corneal Ulcers in Critically Ill Foals in Intensive Care: Case Series of Standard Treatment and Corneal Cross-Linking.
Authors: Imposimato Ilaria, Mariella Jole, Freccero Francesca, Gialletti Rodolfo
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Corneal Cross-Linking for Ulcerated Foals in Intensive Care Corneal ulceration poses a significant clinical challenge in critically ill neonatal foals, particularly those requiring prolonged hospitalisation where frequent topical medication becomes burdensome and infection risk remains elevated. Researchers at an Italian equine centre treated five hospitalised foals with corneal ulcers using riboflavin-UV-A corneal cross-linking (CXL)—a technique previously documented only in adult horses—alongside standard topical therapy controls, with outcomes monitored for up to one year post-treatment. Three foals (five eyes) underwent a single CXL session comprising 20 minutes of riboflavin application followed by 3 minutes of 30 mW/cm² UV-A irradiation; topical antibiotics were discontinued after treatment, whilst two foals received conventional management alone. The CXL-treated foals demonstrated corneal opacity and pain reduction within 3 days, complete ulcer healing between 10–21 days post-treatment, and notably, zero fibrosis or scarring on follow-up, compared to 26–36 days healing in standard-treatment cases. Given the reduced medication frequency, accelerated healing timelines, and absence of corneal pathology in treated foals, CXL warrants consideration as an adjunctive or primary intervention for corneal ulcers in neonatal intensive care patients, particularly where minimising systemic antibiotic burden is clinically desirable.
Read the full abstract on PubMed
Practical Takeaways
- •CXL is a viable alternative or adjunctive treatment option for corneal ulcers in critically ill neonatal foals that may accelerate healing and reduce antibiotic dependence
- •CXL treatment (20 minutes riboflavin + 3 minutes UV-A at 30 mW/cm²) can be performed in intensive care settings and may improve visual outcomes and corneal aesthetics
- •Consider CXL when managing corneal ulcers in hospitalized foals, particularly those at risk of complications from prolonged topical medication
Key Findings
- •Riboflavin/UV-A corneal cross-linking (CXL) reduced corneal opacity and pain within 3 days in treated foals
- •CXL-treated ulcers healed in 10-21 days post-treatment versus 26-36 days for standard treatment cases
- •No fibrosis or corneal scarring occurred in any CXL-treated foals, compared to standard treatment outcomes
- •Topical antibiotic frequency was considerably decreased following CXL treatment