Decreased Riboflavin Impregnation Time Does Not Increase the Risk for Endothelial Phototoxicity During Corneal Cross-Linking.

Autor:	Marcovich AL; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.; Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel., Brekelmans J; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.; Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands., Brandis A; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.; Biological Services Department, Weizmann Institute of Science, Rehovot, Israel., Samish I; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel., Pinkas I; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.; Chemical Research Support, Weizmann Institute of Science, Rehovot, Israel., Preise D; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel., Sasson K; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel., Feine I; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel., Goz A; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.; Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel., Dickman MM; Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands., Nuijts RMMA; Department of Ophthalmology, Maastricht University Medical Center, Maastricht, The Netherlands., Scherz A; Plant and Environmental Sciences Department, Weizmann Institute of Science, Rehovot, Israel.
Jazyk:	angličtina
Zdroj:	Translational vision science & technology [Transl Vis Sci Technol] 2020 May 11; Vol. 9 (6), pp. 4. Date of Electronic Publication: 2020 May 11 (Print Publication: 2020).
DOI:	10.1167/tvst.9.6.4
Abstrakt:	Purpose: To evaluate the riboflavin (RF) concentration and distribution in the corneal stroma and the risk for endothelial photodamage during corneal crosslinking (CXL) following 10- and 30-minute impregnation. Methods: De-epithelialized rabbit corneas were subjected to impregnation for 10 and 30 minutes with different RF formulations. Human corneal endothelial cells (HCECs) were subjected to different RF concentrations and ultraviolet A (UVA) dosages. Assays included fluorescence imaging, absorption spectroscopy of corneal buttons and anterior chamber humor, and cell viability staining. Results: After 10 and 30 minutes of impregnation, respectively, anterior chamber fluid showed an RF concentration of (1.6 ± 0.21)•10 -4 % and (5.4 ± 0.21)•10 -4 %, and trans-corneal absorption reported an average corneal RF concentration of 0.0266% and 0.0345%. This results in a decrease in endothelial RF concentration from 0.019% to 0.0056%, whereas endothelial UVA irradiance increases by 1.3-fold when changing from 30 to 10 minutes of impregnation. HCEC viability in cultures exposed to UVA illumination and RF concentrations as concluded for the endothelium after 10- and 30-minute impregnation was nonstatistically different at 51.0% ± 3.9 and 41.3 ± 5.0%, respectively. Conclusions: The risk for endothelial damage in CXL by RF/UVA treatment does not increase by shortened impregnation because the 30% increase in light intensity is accompanied by a 3.4-fold decrease of the RF concentration in the posterior stroma. This is substantiated by similar endothelial cell toxicity seen in vitro, which in fact appears to favor 10-minute impregnation. Translational Relevance: This study offers compelling arguments for (safely) shortening RF impregnation duration, reducing patients' burden and costly operation room time. Competing Interests: Disclosure: A.L. Marcovich, Steba Biotech (P), Yeda Weizmann (P), EyeYon Medical (C, P), Mor Isum (P), Shire (C), Johnson & Johnson (C); J. Brekelmans, None; A. Brandis, Steba Biotech (P); I. Samish, None; I. Pinkas, None; D. Preise, None; K. Sasson, None; I. Feine, None; A. Goz, None; M.M. Dickman, None; R.M.M.A. Nuijts, Johnson & Johnson (S), Alcon (C, L, S), Asico (C, P), Bausch & Lomb (S), Carl-Zeiss (S), HumanOptics (S), Ophtec (S), Oculentis (S), TheaPharma (C, S); A. Scherz, Steba Biotech (C, P) (Copyright 2020 The Authors.)
Databáze:	MEDLINE
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