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Home / Equine Research Bank / Vet Ophthalmol / Green Light-Activated Rose Bengal Cross-Linking in 81 Horses...
Veterinary ophthalmology2026; 29(1); e70137; doi: 10.1111/vop.70137

Green Light-Activated Rose Bengal Cross-Linking in 81 Horses With Complex Corneal Ulcers and Stromal Abscesses.

Abstract: To assess the efficacy and safety of Rose Bengal and green light corneal cross-linking (RGX) as an adjunctive treatment for complicated corneal ulcers and stromal abscesses in horses. Methods: A retrospective analysis included 81 horses (82 eyes) treated with RGX between 2018 and 2024. Cases involved complicated corneal diseases such as melting keratitis, fungal keratitis, deep stromal defects, and stromal abscesses. Treatment consisted of topical or iontophoretic administration of 1% Rose Bengal followed by green light irradiation (550 nm; 150 J/cm) for 10 min. Most procedures (76.8%) were carried out under standing sedation. RGX was combined with adjunctive surgical procedures in 74 eyes (90.2%). Clinical evolution, epithelialization time, and complications were recorded. Results: Ocular comfort markedly improved within 1 week in all horses. Keratomalacia resolved within 24 h post-RGX in 80% of affected eyes. Fluorescein-negative corneal epithelialization was achieved in 86.6% of cases during hospitalization, with a mean healing time of 18.6 ± 7.3 days. Complications were observed in 9.7% of eyes, predominantly associated with fungal keratitis. Rescue therapies, including repeat RGX and/or surgical procedures, were successful in all but one case, which ultimately required enucleation. The overall success rate, defined as globe preservation and ulcer resolution, was 98.8%. Conclusions: RGX represents a safe and effective adjunctive treatment modality for complicated corneal ulcers and stromal abscesses in horses. The procedure is well tolerated, can be performed under standing sedation, and may significantly reduce the frequency and intensity of postoperative topical therapy.
© 2026 American College of Veterinary Ophthalmologists.
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Publication Date: 2026-01-06 PubMed ID: 41492206DOI: 10.1111/vop.70137Google Scholar: Lookup
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Summary

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Overview

  • This study evaluates the effectiveness and safety of Rose Bengal and green light corneal cross-linking (RGX) as an additional treatment for complex corneal ulcers and stromal abscesses in horses.
  • The treatment was tested on 81 horses with various complicated corneal diseases and involved applying Rose Bengal dye followed by green light exposure to promote healing.

Introduction and Background

  • Corneal ulcers and stromal abscesses are serious eye conditions in horses that can lead to vision loss or the need for eye removal.
  • Traditional treatments can be prolonged and complicated, especially in cases involving fungal infections or deep corneal damage.
  • Rose Bengal green light cross-linking (RGX) offers a novel, adjunctive therapy using a photosensitizing dye activated by green light to strengthen corneal tissue and aid healing.

Methods

  • Design: Retrospective analysis from 2018 to 2024 involving 81 horses (82 eyes) with complicated corneal conditions including melting keratitis, fungal keratitis, deep stromal defects, and stromal abscesses.
  • Treatment: Application of 1% Rose Bengal to the affected eye either topically or via iontophoresis followed by 10 minutes of green light irradiation at 550 nm wavelength and an energy dose of 150 J/cm².
  • Most procedures (76.8%) performed under standing sedation, avoiding general anesthesia.
  • RGX was used alongside other surgical treatments in 74 eyes (90.2%) to optimize outcomes.
  • Data collected included clinical progression, time to corneal epithelial healing (fluorescein-negative), and incidence of complications.

Results

  • Ocular comfort improved significantly in all horses within one week post-treatment.
  • Keratomalacia (corneal tissue melting) resolved rapidly, within 24 hours after RGX, in 80% of cases.
  • Successful corneal epithelialization (healing of the corneal surface) occurred in 86.6% of cases during hospitalization, with an average healing time of approximately 18.6 days (±7.3 days).
  • Complications were relatively low, occurring in 9.7% of eyes, mostly linked to fungal keratitis cases.
  • Rescue therapies such as repeat RGX treatment or additional surgeries were effective for all but one horse, where enucleation (removal of the eye) was ultimately necessary.
  • The overall treatment success rate was very high at 98.8%, defined by both preservation of the globe and ulcer resolution.

Conclusions

  • RGX is a safe and effective adjunctive treatment for horses with complicated corneal ulcers and stromal abscesses.
  • The procedure is well tolerated with most horses undergoing treatment without general anesthesia, reducing risks and recovery time.
  • RGX may reduce the need for intensive postoperative topical medications, potentially simplifying aftercare.
  • These results support further use and study of RGX as part of a multimodal approach to managing complex equine corneal diseases.

Cite This Article

APA
Goetz M, Cremoux M, Lassalle L, Douet JY. (2026). Green Light-Activated Rose Bengal Cross-Linking in 81 Horses With Complex Corneal Ulcers and Stromal Abscesses. Vet Ophthalmol, 29(1), e70137. https://doi.org/10.1111/vop.70137

Publication

Veterinary ophthalmology
ISSN: 1463-5224
NlmUniqueID: 100887377
Country: England
Language: English
Volume: 29
Issue: 1
Pages: e70137

Researcher Affiliations

Goetz, Mathilde
  • CHUVAC, Université de Toulouse, ENVT, Toulouse, France.
Cremoux, Matthieu
  • CHVE la Clinique du Cheval, Grenade sur Garonne, France.
Lassalle, Laura
  • Clinique Vétérinaire D'amikuze, Behasque Lapiste, France.
Douet, Jean-Yves
  • CHUVAC, Université de Toulouse, ENVT, Toulouse, France.
  • IHAP, Université de Toulouse, INRAE, ENVT, Toulouse, France.

MeSH Terms

  • Animals
  • Horses
  • Corneal Ulcer / veterinary
  • Corneal Ulcer / drug therapy
  • Corneal Ulcer / therapy
  • Horse Diseases / drug therapy
  • Horse Diseases / therapy
  • Retrospective Studies
  • Female
  • Male
  • Rose Bengal / therapeutic use
  • Abscess / veterinary
  • Abscess / drug therapy
  • Abscess / therapy
  • Photosensitizing Agents / therapeutic use
  • Cross-Linking Reagents / therapeutic use
  • Treatment Outcome
  • Green Light

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