Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release
The purpose of this study was to evaluate the effectiveness and safety of a novel buffered riboflavin solution approved for corneal cross-linking (CXL) in progressive keratoconus and secondary corneal ectasia. Following the in vivo preclinical study performed on New Zealand rabbits comparing the nov...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/6/1324 |
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| author | Cosimo Mazzotta Marco Ferrise Guido Gabriele Paolo Gennaro Alessandro Meduri |
| author_facet | Cosimo Mazzotta Marco Ferrise Guido Gabriele Paolo Gennaro Alessandro Meduri |
| author_sort | Cosimo Mazzotta |
| collection | DOAJ |
| description | The purpose of this study was to evaluate the effectiveness and safety of a novel buffered riboflavin solution approved for corneal cross-linking (CXL) in progressive keratoconus and secondary corneal ectasia. Following the in vivo preclinical study performed on New Zealand rabbits comparing the novel 0.25% riboflavin solution (Safecross<sup>®</sup>) containing 1% hydroxypropyl methylcellulose (HPMC) with a 0.1% riboflavin solution containing 0.10% EDTA, accelerated epithelium-off CXL was performed on 10 patients (10 eyes treated, with the contralateral eye used as control) through UV-A at a power setting of 9 mW/cm<sup>2</sup> with a total dose of 5.4 J/cm<sup>2</sup>. Re-epithelialization was evaluated in the postoperative 7 days by fluorescein dye test at biomicroscopy; endothelial cell count and morphology (ECD) were analyzed by specular microscopy at the 1st and 6th month of follow-up and demarcation line depth (DLD) measured by anterior segment optical coherence tomography (AS-OCT) one month after the treatment. We observed complete re-epithelization in all eyes between 72 and 96 h after surgery (88 h on average). ECD and morphology remained unchanged in all eyes. DLD was detected at a mean depth of 362 ± 50 µm, 20% over solutions with equivalent dosage. SafeCross<sup>®</sup> riboflavin solution chemically-boosted corneal cross-linking seems to optimize CXL oxidative reaction by higher superoxide anion release, improving DLD by a factor of 20%, without adverse events for corneal endothelium. |
| first_indexed | 2024-03-10T12:58:51Z |
| format | Article |
| id | doaj.art-47df608455084851aca090f3d83836d3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:58:51Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-47df608455084851aca090f3d83836d32023-11-21T11:40:23ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01106132410.3390/jcm10061324Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion ReleaseCosimo Mazzotta0Marco Ferrise1Guido Gabriele2Paolo Gennaro3Alessandro Meduri4Departmental Ophthalmology Unit and USL Toscana Sud-Est, 53100 Siena, ItalySiena Crosslinking Center, Via Sandro Pertini 7, 53100 Siena, ItalyDepartment of Oral and Maxillofacial Surgery, “Le Scotte” Hospital, Viale M. Bracci, 53100 Siena, ItalyDepartment of Oral and Maxillofacial Surgery, “Le Scotte” Hospital, Viale M. Bracci, 53100 Siena, ItalyUnit of Ophthalmology, Department of Biomedical Sciences, Dentistry, Morphological and Functional Imaging, University of Messina, 98100 Messina, ItalyThe purpose of this study was to evaluate the effectiveness and safety of a novel buffered riboflavin solution approved for corneal cross-linking (CXL) in progressive keratoconus and secondary corneal ectasia. Following the in vivo preclinical study performed on New Zealand rabbits comparing the novel 0.25% riboflavin solution (Safecross<sup>®</sup>) containing 1% hydroxypropyl methylcellulose (HPMC) with a 0.1% riboflavin solution containing 0.10% EDTA, accelerated epithelium-off CXL was performed on 10 patients (10 eyes treated, with the contralateral eye used as control) through UV-A at a power setting of 9 mW/cm<sup>2</sup> with a total dose of 5.4 J/cm<sup>2</sup>. Re-epithelialization was evaluated in the postoperative 7 days by fluorescein dye test at biomicroscopy; endothelial cell count and morphology (ECD) were analyzed by specular microscopy at the 1st and 6th month of follow-up and demarcation line depth (DLD) measured by anterior segment optical coherence tomography (AS-OCT) one month after the treatment. We observed complete re-epithelization in all eyes between 72 and 96 h after surgery (88 h on average). ECD and morphology remained unchanged in all eyes. DLD was detected at a mean depth of 362 ± 50 µm, 20% over solutions with equivalent dosage. SafeCross<sup>®</sup> riboflavin solution chemically-boosted corneal cross-linking seems to optimize CXL oxidative reaction by higher superoxide anion release, improving DLD by a factor of 20%, without adverse events for corneal endothelium.https://www.mdpi.com/2077-0383/10/6/1324accelerated cross-linkingcross-linkingepithelium-offkeratoconusriboflavinSafeCross |
| spellingShingle | Cosimo Mazzotta Marco Ferrise Guido Gabriele Paolo Gennaro Alessandro Meduri Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release Journal of Clinical Medicine accelerated cross-linking cross-linking epithelium-off keratoconus riboflavin SafeCross |
| title | Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release |
| title_full | Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release |
| title_fullStr | Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release |
| title_full_unstemmed | Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release |
| title_short | Chemically-Boosted Corneal Cross-Linking for the Treatment of Keratoconus through a Riboflavin 0.25% Optimized Solution with High Superoxide Anion Release |
| title_sort | chemically boosted corneal cross linking for the treatment of keratoconus through a riboflavin 0 25 optimized solution with high superoxide anion release |
| topic | accelerated cross-linking cross-linking epithelium-off keratoconus riboflavin SafeCross |
| url | https://www.mdpi.com/2077-0383/10/6/1324 |
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