Corneal Collagen Fibril Changes After Ultraviolet A/Riboflavin Corneal Crosslinking

Xia, Yu; Liu, Baichen; Fan, Zhengjun; Peng, Xueping

doi:10.1097/ico.0000000000000017

Cited by 11 publications

(7 citation statements)

References 20 publications

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“…There has been growing interest in clarifying the molecular structural and biomechanical changes that occur after treatment, and such investigations have conventionally been done using light and electron microscopy. Xia et al 11 used polarized light microscopy and observed a microscopically detectable corneal haze with a significant increase in type III collagen fibrils between 30 and 90 days after crosslinking therapy with riboflavin and ultraviolet light. Karl et al 22 used electron microscopy to examine how the fibrils change after crosslinking and found similar changes in structure with blue light treatment.…”

Section: Discussionmentioning

confidence: 99%

Changes in Collagen Structure and Permeability of Rat and Human Sclera After Crosslinking

Guo

Miao

Yang

et al. 2020

Trans. Vis. Sci. Tech.

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Purpose To use second harmonic generation imaging and fluorescence recovery after photobleaching to demonstrate alterations in scleral collagen structure and permeability after crosslinking in rat and human eyes. Methods Excised rat and human scleras were imaged ex vivo with an inverted two-photon excitation fluorescence microscope before and after photochemical crosslinking using riboflavin and 405-nm laser light. Fluorescence recovery after photobleaching was applied to measure the diffusion of fluorescein isothiocyanate–dextran across the sclera. Results Crosslinking caused scleral collagen fibers to become wavier and more densely packed, with surface collagen being more affected than deeper collagen fibers. Crosslinked sclera showed significantly decreased permeability in the irradiation zone and also extended as far as 250 µm outside the irradiation zone. Conclusions Photochemical crosslinking induced changes in scleral structure and permeability that extended to tissue even outside the irradiation zone. Translational Relevance Ultrastructural changes associated with the emerging clinical technique of photochemical scleral crosslinking have not been well characterized. We demonstrate not only changes in scleral collagen by second harmonic generation imaging but also the associated functional changes in tissue permeability by fluorescence recovery after photobleaching. We report the novel finding of reduced permeability extending well beyond the direct irradiation zone. This has implications for control in the clinical setting.

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Section: Discussionmentioning

confidence: 99%

Changes in Collagen Structure and Permeability of Rat and Human Sclera After Crosslinking

Guo

Miao

Yang

et al. 2020

Trans. Vis. Sci. Tech.

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“…Die frühen physiologischen Veränderungen umfassen die direkten Folgeerscheinungen durch das Crosslinking. Dazu gehören die Erosio corneae und eine transiente stromale Trübung ("Haze") [44,45,[130][131][132]. Diese vorübergehende homogene Trübung sollte jedoch nicht mit einer längerfristigen Hornhauttrübung bzw.…”

Section: Veränderungen Nach Crosslinkingunclassified

“…population der Keratozyten und der Kollagensynthese bzw. -zersetzung wurde beschrieben [131,134,135].…”

Section: Veränderungen Nach Crosslinkingunclassified

Morphologische Hornhautveränderungen nach Crosslinking bei Keratokonus

Müller

Löffler

Kohlhaas

et al. 2017

Klin Monatsbl Augenheilkd

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Keratoconus is a relatively common (1 : 2000) bilateral disease leading to a change in biochemical and biomechanical corneal structure as well as thinning and ectasia. For more than 10 years, crosslinking has been a therapeutic option in cases of progression. Using riboflavin and UVA-radiation, the anterior corneal stroma (300 µm) gets stiffened by crosslinking of collagen fibers. When protocols and limitations are adhered, the procedure is described to be effective and of low-risk. This review gives an overview about physiologic and pathologic changes in keratoconic corneas before and after crosslinking. Based on histopathologic examination, the current knowledge in published literature is reviewed and is complemented by our own investigations.

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“…Corneal injury involves superficial penetration of the epithelium and anterior part of the stroma, leading to tissue repair, which is often the onset of corneal fibrosis [ 6 ]. Myofibroblasts synthesize the extracellular matrix (ECM), and corneal collagen is the primary ECM component involved in the wound-healing response to corneal damage [ 7 ]. The corneal collagen reflects the stability of the cornea.…”

Section: Introductionmentioning

confidence: 99%

The Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Anterior Segment

Wang

Yan³

et al. 2017

Journal of Ophthalmology

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Purpose. To evaluate the safety of high-intensity focused ultrasound keratoplasty as a treatment for presbyopia by examining its effect on the rabbit anterior segment. Methods. The right corneas of 36 New Zealand rabbits were treated with HIFU keratoplasty. The animals were sacrificed at 1, 7, 15, 30, 60, and 90 days after operation. Collagen type I, MMP-2, and MMP-9 were evaluated using immunohistochemistry. For the detection of apoptosis, the TUNEL method was applied. The SOD and MDA levels were analyzed with assay kits. Results. Collagen type I, MMP-2, and MMP-9 levels were altered after the operation but returned to normal within 90 days. The apoptotic index (AI) of the corneal cells decreased from 1 to 30 days gradually. No apoptosis was observed in the epithelial cells of the lens, and the SOD and MDA levels were normal at any time point. Conclusion. After HIFU keratoplasty, the histomorphology of the cornea changed, the corneal collagen type I levels decreased, the corneal MMP-2 and MMP-9 levels increased, and the corneal cells underwent apoptosis for a period of time. Ninety days after the operation, the levels returned to normal, and the lenses were not affected. Thus, HIFU presents good biological safety for eyes.

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Corneal Collagen Fibril Changes After Ultraviolet A/Riboflavin Corneal Crosslinking

Abstract: These findings suggest that ultraviolet A/riboflavin crosslinking results in collagen type 3 synthesis and degradation, which may offer at least a partial explanation for the formation of corneal haze.

Cited by 11 publications

References 20 publications

Changes in Collagen Structure and Permeability of Rat and Human Sclera After Crosslinking

Changes in Collagen Structure and Permeability of Rat and Human Sclera After Crosslinking

Morphologische Hornhautveränderungen nach Crosslinking bei Keratokonus

The Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Anterior Segment

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