Corneal Wound Repair After Rose Bengal and Green Light Crosslinking: Clinical and Histologic Study

Gallego‐Muñoz, Patricia; Ibares‐Frías, Lucía; Lorenzo, E.; Marcos, Susana; Pérez-Merino, Pablo; Békési, Nándor; Kochevar, Irene E.; Martínez‐García, Carmen

doi:10.1167/iovs.16-21365

Cited by 27 publications

(39 citation statements)

References 44 publications

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“…In more recent studies, RB 2− phototoxicity to keratocytes in the corneal stroma has been observed and studied , which was consistent with earlier studies showing that R5P 2− photosensitization causes phototoxicity in the same tissue . The reason for greater photocytotoxicity in corneal keratocytes compared with dermal fibroblasts is not clear.…”

Section: Photosensitized Protein Crosslinking Versus Photodynamic Effectsupporting

confidence: 76%

“…In vivo , RB 2− ‐photosensitized crosslinking increased cornea stiffness 1.9‐fold after 1 day and 2.8‐fold after 1 month, as measured by tensiometry and by larger factors when estimated from air puff corneal deformation imaging . Significantly, the same level and depth of stromal cell death was found after RB 2− ‐photosensitized crosslinking as for control eyes that were only de‐epithelialized . When the potential problem of green light damage to the retina was assessed in rabbit eyes, RB 2− ‐photosensitized crosslinking did not cause breakdown of the blood‐retina barrier as assessed by fluorescein angiography and the retina appeared normal histologically .…”

Section: Clinical Applications Of Photochemical Crosslinkingmentioning

confidence: 82%

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Medical Applications of Rose Bengal‐ and Riboflavin‐Photosensitized Protein Crosslinking

Redmond

Kochevar

2019

Photochem & Photobiology

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This review summarizes research on many of the potential applications of photosensitized crosslinking of tissue proteins in surgery and current knowledge of the photochemical mechanisms underlying formation of the covalent protein–protein crosslinks involved. Initially developed to close wounds or reattach tissues, protein photocrosslinking has also been demonstrated to stiffen and strengthen tissues, decrease inflammatory responses and facilitate tissue bioengineering. These treatments appear to result largely from crosslinks within and between collagen molecules in tissue that typically form by an oxygen‐dependent mechanism. Surgical applications discussed include sealing wounds in skin, cornea and bowel; reattaching severed nerves, blood vessels and tendons; strengthening cornea and vein; reducing capsular contracture after breast implants; and regenerating joint cartilage.

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Section: Photosensitized Protein Crosslinking Versus Photodynamic Effectsupporting

confidence: 76%

Section: Clinical Applications Of Photochemical Crosslinkingmentioning

confidence: 82%

Medical Applications of Rose Bengal‐ and Riboflavin‐Photosensitized Protein Crosslinking

Redmond

Kochevar

2019

Photochem & Photobiology

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“…The safety of the treatment was demonstrated through histological analyses showing no thermal damage to retina and iris cells of rabbits after PTB in vivo. 28 Over recent years, more studies on the comparison between collagen crosslinking induced by photo-activated riboflavin and RB on ex vivo and in vivo efficacy, 29 corneal healing response, 30 and collagenase degradation 31 have been performed, showing that treatment with photo-activated RB is more effective than with riboflavin. Based on these results, photo-activated RB to crosslink corneal tissue is considered an attractive therapeutic approach for keratoconus and other disorders and its clinical application in humans should be explored in the near future.…”

Section: Photo-and Sono-activated Rose Bengalmentioning

confidence: 99%

Biomedical Applications of Photo- and Sono-Activated Rose Bengal: A Review

Vanerio

Stijnen

Mol³

et al. 2019

Photobiomodulation, Photomedicine, and Laser Surgery

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DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:

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“…Corneal thickness and cell counting were carried out using methods described in a previous study. 22 Briefly, in each cornea, three measurements of corneal full thickness were taken at 340 magnification. Cells were then counted at 3100 magnification using the Touch Count function from Cell A software (Olympus).…”

Section: Cell Countingmentioning

confidence: 99%

“…Cross-linking with RGX involves applying RB onto de-epithelialized corneas for 2 minutes and then exposure to green light (532 nm) for 7 minutes. Both cross-linking protocols have been studied clinically and histologically in animal models, 8,15,21,22 but none of these studies directly compared the two methods.…”

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confidence: 99%

Rose Bengal and Green Light Versus Riboflavin–UVA Cross-Linking: Corneal Wound Repair Response

Lorenzo-Martín

Gallego‐Muñoz

Ibares‐Frías

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To study corneal wound healing after two cross-linking techniques using either rose bengal and green light (RGX) or the conventional treatment using riboflavin and UVA radiation (UVX). METHODS. Corneas of New Zealand rabbits were monolaterally treated with UVX (21 eyes) or RGX (25 eyes). Treatments involved corneal de-epithelialization (8-mm diameter), soaking with photosensitizer (0.1% riboflavin in 20% dextran for 30 minutes for UVX; 0.1% rose bengal for 2 minutes for RGX), and light irradiation (370 nm, 3 mW/cm 2 , 30 minutes for UVX; 532 nm, 0.25 W/cm 2 , 7 minutes for RGX). Contralateral eyes were used as controls. Clinical follow-up included fluorescein staining, haze measurement, and pachymetry. Healing events analyzed after euthanasia at 2, 30, and 60 days included cell death (TUNEL assay), cell proliferation (BrdU [bromodeoxyuridine] immunofluorescence), and differentiation to myofibroblasts (a-SMA [alpha smooth muscle actin] immunohistochemistry). RESULTS. Re-epithelialization and pachymetries were similar after RGX and UVX. The haze from day 1 to 15 was greater after UVX. Cell death was deeper after UVX, being localized in the anterior and middle stroma, and was superficial (anterior third) after RGX. Cell proliferation appeared after 2 days and was localized in the middle and posterior stroma in the UVX group but was superficial in the RGX group. After 60 days the number of stromal cells had not returned to the control number in either group. CONCLUSIONS. The deeper and longer-lasting cell damage caused by UVX compared to RGX may underlie the slower cell repopulation after UVX and other differences in healing. Shallower damage and a shorter treatment time suggest that RGX may be appropriate for stiffening thin corneas.

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Corneal Wound Repair After Rose Bengal and Green Light Crosslinking: Clinical and Histologic Study

Abstract: The healing response in corneas after RGX is very similar to that observed after DE alone, suggesting that, along with its short treatment time and limited effect on keratocytes, RGX displays good potential for clinical cornea stiffening.

Cited by 27 publications

References 44 publications

Medical Applications of Rose Bengal‐ and Riboflavin‐Photosensitized Protein Crosslinking

Medical Applications of Rose Bengal‐ and Riboflavin‐Photosensitized Protein Crosslinking

Biomedical Applications of Photo- and Sono-Activated Rose Bengal: A Review

Rose Bengal and Green Light Versus Riboflavin–UVA Cross-Linking: Corneal Wound Repair Response

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