Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion
Abstract Purpose This study evaluated the effect of high-fluence accelerated corneal cross-linking on the resistance to enzymatic digestion, assessing two chromophore/light combinations: riboflavin/UV-A light (RF/UV-A) and rose bengal/green light (RB/green). Methods Freshly prepared ex-vivo porcine...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Ophthalmology |
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| Online Access: | https://doi.org/10.1186/s12886-024-03293-0 |
| _version_ | 1797276699610578944 |
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| author | Nikki L. Hafezi M. Enes Aydemir Nan-Ji Lu Emilio A. Torres-Netto Mark Hillen Carina Koppen |
| author_facet | Nikki L. Hafezi M. Enes Aydemir Nan-Ji Lu Emilio A. Torres-Netto Mark Hillen Carina Koppen |
| author_sort | Nikki L. Hafezi |
| collection | DOAJ |
| description | Abstract Purpose This study evaluated the effect of high-fluence accelerated corneal cross-linking on the resistance to enzymatic digestion, assessing two chromophore/light combinations: riboflavin/UV-A light (RF/UV-A) and rose bengal/green light (RB/green). Methods Freshly prepared ex-vivo porcine corneas (n = 189) were divided into 8 groups groups. Group A corneas were unirradiated controls without chromophore soaking (A0), or soaked with riboflavin (A1) or rose bengal (A2). Group B corneas underwent accelerated epi-off RF/UV-A CXL at fluences of 5.4 J/cm² (B1), 10 J/cm² (B2), or 15 J/cm² (B3). Group C corneas underwent accelerated epi-off RB/green CXL at fluences of either 10 J/cm² (C1) or 15 J/cm² (C2). Following CXL, all corneas were digested in 0.3% collagenase-A solution, and the time until complete dissolution was measured. Results Non-irradiated controls exposed to RF and RB enhanced corneal resistance to collagenase digestion, with RB having a stronger effect than RF. RF/UV-A-treated corneas showed significantly increased digestion resistance with increasing fluence levels. RB/green-treated corneas displayed enhanced digestion resistance with each increase in fluence up to 10 J/cm²; a 15 J/cm² fluence yielded similar digestion resistance times to a 10 J/cm² fluence, suggesting a plateau effect in accelerated RB/green CXL protocols. Conclusions When compared to standard-fluence treatments, high-fluence accelerated epi-off CXL using both riboflavin and rose bengal significantly increases resistance to enzymatic digestion. The optimal settings for clinical protocols might be 15 J/cm² (30 mW/cm² for 8 min 20 s) for RF/UV-A and 10 J/cm² (15 mW/cm² for 11 min 7 s) for RB/Green Light. |
| first_indexed | 2024-03-07T15:31:59Z |
| format | Article |
| id | doaj.art-b1cea8c2aef342f48050de66753799e4 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-03-07T15:31:59Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
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| series | BMC Ophthalmology |
| spelling | doaj.art-b1cea8c2aef342f48050de66753799e42024-03-05T16:23:19ZengBMCBMC Ophthalmology1471-24152024-01-012411710.1186/s12886-024-03293-0Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestionNikki L. Hafezi0M. Enes Aydemir1Nan-Ji Lu2Emilio A. Torres-Netto3Mark Hillen4Carina Koppen5Faculty of Medicine, University of AntwerpELZA InstituteFaculty of Medicine, University of AntwerpELZA InstituteELZA InstituteFaculty of Medicine, University of AntwerpAbstract Purpose This study evaluated the effect of high-fluence accelerated corneal cross-linking on the resistance to enzymatic digestion, assessing two chromophore/light combinations: riboflavin/UV-A light (RF/UV-A) and rose bengal/green light (RB/green). Methods Freshly prepared ex-vivo porcine corneas (n = 189) were divided into 8 groups groups. Group A corneas were unirradiated controls without chromophore soaking (A0), or soaked with riboflavin (A1) or rose bengal (A2). Group B corneas underwent accelerated epi-off RF/UV-A CXL at fluences of 5.4 J/cm² (B1), 10 J/cm² (B2), or 15 J/cm² (B3). Group C corneas underwent accelerated epi-off RB/green CXL at fluences of either 10 J/cm² (C1) or 15 J/cm² (C2). Following CXL, all corneas were digested in 0.3% collagenase-A solution, and the time until complete dissolution was measured. Results Non-irradiated controls exposed to RF and RB enhanced corneal resistance to collagenase digestion, with RB having a stronger effect than RF. RF/UV-A-treated corneas showed significantly increased digestion resistance with increasing fluence levels. RB/green-treated corneas displayed enhanced digestion resistance with each increase in fluence up to 10 J/cm²; a 15 J/cm² fluence yielded similar digestion resistance times to a 10 J/cm² fluence, suggesting a plateau effect in accelerated RB/green CXL protocols. Conclusions When compared to standard-fluence treatments, high-fluence accelerated epi-off CXL using both riboflavin and rose bengal significantly increases resistance to enzymatic digestion. The optimal settings for clinical protocols might be 15 J/cm² (30 mW/cm² for 8 min 20 s) for RF/UV-A and 10 J/cm² (15 mW/cm² for 11 min 7 s) for RB/Green Light.https://doi.org/10.1186/s12886-024-03293-0Corneal cross-linkingCollagenaseCorneaDigestionRiboflavinUltraviolet |
| spellingShingle | Nikki L. Hafezi M. Enes Aydemir Nan-Ji Lu Emilio A. Torres-Netto Mark Hillen Carina Koppen Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion BMC Ophthalmology Corneal cross-linking Collagenase Cornea Digestion Riboflavin Ultraviolet |
| title | Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion |
| title_full | Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion |
| title_fullStr | Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion |
| title_full_unstemmed | Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion |
| title_short | Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion |
| title_sort | effect of accelerated high fluence riboflavin and rose bengal mediated corneal cross linking on resistance to enzymatic digestion |
| topic | Corneal cross-linking Collagenase Cornea Digestion Riboflavin Ultraviolet |
| url | https://doi.org/10.1186/s12886-024-03293-0 |
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