Reduction of Stromal Swelling Pressure after UVA-Riboflavin Cross-Linking
Reduction of Stromal Swelling Pressure after UVA-Riboflavin Cross-Linking
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DOI：
10.1167/iovs.12-10346
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发表时间：
2013-03-01
影响因子：
4.4
通讯作者：
Hjortdal, Jesper
中科院分区：
文献类型：
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作者：
Sondergaard, Anders P.;Ivarsen, Anders;Hjortdal, Jesper
目的.我们评估UVA-核黄素胶原交联（CXL）是否降低猪和人角膜离体基质肿胀压（SP）。将猪角膜（n = 35）分为5组：全层纽扣、核黄素处理的纽扣、CXL处理的纽扣、核黄素处理的前后板层以及CXL处理的前后板层。将核黄素或CXL处理的人角膜（n = 6）切成前板层和后板层。记录在生理盐水中溶胀期间由样本施加的力并计算SP。获得用于固体校正的干重。在全层猪钛板中，在5%压缩下，与核黄素治疗（68.13 +/- 11.39 mm Hg，P = 0.02）相比，CXL治疗（40.07 +/- 3.86 mm Hg）后观察到SP显著降低。此外，与核黄素组（25 mm Hg）相比，在5%压缩下，发现CXL处理的人前椎板（9.9 mm Hg）中SP降低的趋势。在猪前板中，与核黄素组相比，CXL组中观察到SP显著降低（P < 0.001，双因素ANOVA）。同样，在猪后椎板中，与单独的核黄素相比，在CXL组中观察到显著的SP降低（P < 0.05，双因素ANOVA）。当比较CXL和核黄素组时，人后椎板的SP没有差异。我们的研究表明CXL后猪和人角膜前基质SP显著减少。这一发现表明，CXL可以降低角膜SP在体内，从而减轻水肿，改善视力。因此，在临床环境中，患有角膜水肿的患者可以从CXL治疗中受益。（Invest Ophthalmol维斯科学。2013;54：1625-1634）DOI：10.1167/iovs.12-10346
PURPOSE. We evaluated whether UVA-riboflavin collagen cross-linking (CXL) reduces stromal swelling pressure (SP) in porcine and human corneas ex vivo.METHODS. Porcine corneas (n = 35) were divided into five groups: Full-thickness buttons, riboflavin-treated buttons, CXL-treated buttons, riboflavin-treated anterior and posterior lamellae, and CXL-treated anterior and posterior lamellae. Riboflavin-or CXL-treated human corneas (n = 6) were cut into anterior and posterior lamellae. The force exerted by the specimens during swelling in saline was recorded and SP was calculated. Dry weights were obtained for solids correction.RESULTS. In full-thickness porcine buttons, a significantly reduced SP was observed after CXL (40.07 +/- 3.86 mm Hg) compared to riboflavin treatment (68.13 +/- 11.39 mm Hg, P = 0.02) at 5% compression. Also, a trend toward reduced SP in the CXL-treated anterior human lamellae (9.9 mm Hg) was found compared to the riboflavin group (25 mm Hg) at 5% compression. In the anterior porcine lamellae a significant SP reduction was observed in the CXL group versus the riboflavin group (P < 0.001, two-way ANOVA). Likewise, in the posterior porcine lamellae, a significant SP reduction was observed in the CXL group versus riboflavin alone (P < 0.05, two-way ANOVA). Posterior human lamellae did not differ in SP when comparing CXL and riboflavin groups.CONCLUSIONS. Our study demonstrated a significant reduction in anterior stromal SP in porcine and human corneas after CXL. This finding suggested that CXL may reduce corneal SP in vivo, and thereby reduce edema and improve vision. Thus, in the clinical setting, patients suffering from corneal edema may benefit from CXL treatment. (Invest Ophthalmol Vis Sci. 2013;54:1625-1634) DOI:10.1167/iovs.12-10346