An investigation into corneal enzymatic resistance following epithelium-off and epithelium-on corneal cross-linking protocols.
An investigation into corneal enzymatic resistance following epithelium-off and epithelium-on corneal cross-linking protocols.
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DOI：
10.1016/j.exer.2016.10.014
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发表时间：
2016-12
影响因子：
3.4
通讯作者：
Meek, Keith M.
中科院分区：
文献类型：
--
作者：
Aldahlawi, Nada H.;Hayes, Sally;O'Brart, David P. S.;O'Brart, Naomi D.;Meek, Keith M.
本研究的目的是调查角膜酶的阻力上皮关闭和核黄素/UVA交联（CXL）。将114只猪眼分为4个非辐照对照组和7个CXL组。后者包括;（i）上皮关闭，0.1%等渗核黄素，9 mW UVA照射10分钟，（ii）破坏的上皮，0.1%低渗核黄素，9 mW UVA照射10分钟，（iii）上皮开启，0.25%低渗核黄素与0.01%苯扎氯铵（BACS），9 mW UVA照射10分钟，（iv）上皮开启，用0.1%核黄素溶液在0.1mA下离子电渗5分钟，9 mW UVA 10分钟或（v）12.5分钟，（vi）上皮开启，用0.25%核黄素和0.01%BACS，用1.0mA持续5分钟和0.5mA持续5分钟25分钟的延长离子电渗方案，9 mW UVA持续10 min或（vii）12.5 min。通过每天测量置于胃蛋白酶溶液中的角膜扣并在消化11天后测量角膜扣干重来评估酶抗性。该研究表明，CXL角膜的酶抗性大于未辐照角膜（p < 0.0001）。上皮脱落的CXL显示出最大的酶抗性（p < 0.0001）。发现延长的离子电渗疗法方案上级所有其他经上皮方案（p < 0.0001）。UVA辐射增加25%显著增加角膜酶抗性（p < 0.0001）。总之，尽管上皮-on CXL在对胃蛋白酶消化的酶抗性方面似乎劣于上皮-off CXL，但上皮-on CXL的结果可通过使用更高浓度的核黄素溶液、更长的离子电渗持续时间和UVA辐射的增加而显著改善。在酶抗性方面，Epi-off CXL上级优于epi-on CXL。Epi-on CXL的有效性可以通过使用延长的离子电渗疗法方案来改善。更高的核黄素浓度和增加的UVA辐射也可以增强epi-on CXL。
The aim of this study was to investigate corneal enzymatic resistance following epithelium off and on riboflavin/UVA cross-linking (CXL). One hundred and fourteen porcine eyes were divided into four non-irradiated control groups and seven CXL groups. The latter comprised; (i) epithelium-off, 0.1% iso-osmolar riboflavin, 9 mW UVA irradiation for 10 min, (ii) disrupted epithelium, 0.1% hypo-osmolar riboflavin, 9 mW UVA for 10 min, (iii) epithelium-on, 0.25% hypo-osmolar riboflavin with 0.01% benzylalkonium chloride (BACS), 9 mW UVA for 10 min, (iv) epithelium-on, 5 min iontophoresis at 0.1 mA for 5 min with 0.1% riboflavin solution, 9 mW UVA for 10 min or (v) 12.5 min, (vi) epithelium-on, prolonged iontophoresis protocol of 25 min with 1.0 mA for 5 min and 0.5 mA for 5 min with 0.25% riboflavin with 0.01% BACS, 9 mW UVA for 10 min or (vii) 12.5 min. Enzymatic resistance was assessed by daily measurement of a corneal button placed in pepsin solution and measurement of corneal button dry weight after 11 days of digestion. This study revealed that the enzymatic resistance was greater in CXL corneas than non-irradiated corneas (p < 0.0001). Epithelium-off CXL showed the greatest enzymatic resistance (p < 0.0001). The prolonged iontophoresis protocol was found to be superior to all other trans-epithelial protocols (p < 0.0001). A 25% increase in UVA radiance significantly increased corneal enzymatic resistance (p < 0.0001). In conclusion, although epithelium-on CXL appears to be inferior to epithelium-off CXL in terms of enzymatic resistance to pepsin digestion, the outcome of epithelium-on CXL may be significantly improved through the use of higher concentrations of riboflavin solution, a longer duration of iontophoresis and an increase in UVA radiance. Epi-off CXL is superior to epi-on CXL in terms of enzymatic resistance. Epi-on CXL effectiveness can be improved by using a prolonged iontophoresis protocol. Higher riboflavin concentrations and increased UVA radiance may also enhance epi-on CXL.
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影响因子：
4.4
作者：
Cassagne, Myriam;Laurent, Camille;Malecaze, Francois
通讯作者：
Malecaze, Francois
影响因子：
3.9
作者：
Davidson, A. E.;Hayes, S.;Tuft, S. J.
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影响因子：
2.8
作者：
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Caporossi, T
影响因子：
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作者：
Kymionis, George D.;Grentzelos, Michael A.;Pallikaris, Aristophanis I.
通讯作者：
Pallikaris, Aristophanis I.
影响因子：
1.6
作者：
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通讯作者：
Kozobolis, Vassilios