Effect of ozone-based eye drops as adjuvant therapy in the management of microbial keratitis in comparison with conventional therapy

Purpose To compare the therapeutic efficacy of ozone-based eye drops as an adjuvant therapy to conventional topical antimicrobial agents in managing microbial keratitis (MK) and evaluate their impact on clinical outcomes using anterior segment optical coherence tomography (AS-OCT). Patients and methods This prospective, comparative study included patients diagnosed with MK at Assiut University Hospital. Participants were divided into two groups: one receiving ozone-based eye drops as adjunctive therapy and the other receiving standard antimicrobial treatment alone. Comprehensive clinical examinations and AS-OCT imaging were conducted to assess the reduction of ulcer size and infiltrate depth. Results The study included 40 eyes from 38 patients, with 20 eyes assigned to each group. Patients were enrolled from December 2021 to December 2023. The mean age was 42.30 years in the ozone group and 46.70 years in the conventional group. The ozone group showed a higher mean percent reduction in ulcer size (83.4±26.6%) versus the nonozone group (70.5±27.08%) with a P value of 0.029. Similarly, the ozone group achieved a greater mean percent reduction in infiltrate depth on AS-OCT (34.8±13.6%) compared with the nonozone group (26.05±10.37%) with a P value of 0.044. Conclusion Ozone-based eye drops, as an adjunct to conventional therapy, offer promising therapeutic potential for managing MK, promoting faster healing and better visual outcomes. AS-OCT serves as a valuable tool for evaluating treatment efficacy and monitoring disease progression.