Riboflavin Osmolar Modification for Transepithelial Corneal Cross-Linking

Raiskup, Frederik; Pinelli, Roberto; Spoerl, Eberhard

doi:10.3109/02713683.2011.637656

Cited by 82 publications

(60 citation statements)

References 32 publications

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“…The use of BAC in rabbit eyes was shown to increase the riboflavin absorption coefficient through an intact epithelium. Nevertheless, the absorption coefficient achieved was only 37% that of epi-off absorption [74]. Slightly different results were shown in a very similar study, where the addition of BAC increased the riboflavin absorption coefficient in epi-on CXL to a level similar to a standard epi-off CXL.…”

Section: Evolution Of Riboflavin: Uva Corneal Collagen Crosslinkingmentioning

confidence: 66%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

166

122

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Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.

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Section: Evolution Of Riboflavin: Uva Corneal Collagen Crosslinkingmentioning

confidence: 66%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

166

122

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“…. Experimental comparative studies in rabbit corneas have shown that CXL of corneas with an intact epithelium using BAC 0.0005% results in an increase in biomechanical rigidity (Young's modulus) of about one-fifth of that induced by standard CXL with epithelial debridement 58 . This is presumably due to limited riboflavin absorption 59 .…”

Section: Technique Modifications Trans -Epithelial Cross-linking (Te mentioning

confidence: 99%

Corneal Collagen Crosslinking with Riboflavin and Ultraviolet - A Irradiation in the Management of Progressive Ectatic Corneal Disorders. Review Article

Eldine

2017

Journal of Ophthalmology and Related Sciences

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Corneal crosslinking (CXL) has been proposed as a new modality to stop progression of keratoconus or secondary corneal ectasia, aiming to prevent progressive visual loss and to delay or avoid corneal transplantation. The possibility of strengthening corneal tissue by means of a photochemical reaction of corneal collagen by the combined action of riboflavin and ultraviolet-A irradiation (UVA), radically modified the conservative management of progressive corneal ectasia. This is a review of the state of the art of CXL. The paper describes basic principles, advantages and limitations of different CXL techniques and possible future evolution of the procedure.

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“…[18][19][20][21] Thus, there are valid reasons for seeking to modify the standard protocol and to perform the treatment with epithelial retention (''epi-ON'' protocols). [22][23][24] Early attempts to accomplish this have included the use of multiple applications of the topical anesthetic, tetracaine 1%, 25,26 20% ethanol solution, 27 0.02% benzalkonium chloride (BAC), 28 0.44% NaCl in combination with 0.01% BAC, 29 or by removing the epithelium in a grid pattern rather than complete debridement 27 to assist the diffusion of RF into the stroma before beginning the irradiation with UVA.…”

Section: Purposementioning

confidence: 99%

Effect of the Synthetic NC-1059 Peptide on Diffusion of Riboflavin across an Intact Corneal Epithelium

Zhang

Sukthankar

Tomich

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.To investigate the effect of the peptide NC-1059 on riboflavin (RF) diffusion across an intact corneal epithelium into the stroma.METHODS. NC-1059 peptide was synthesized by solid-phase synthesis with 9-fluorenylmethoxycarbonyl chemistry, characterized by reversed-phase HPLC, and matrix-assisted laser desorption ionization time-of-flight mass spectroscopy. The diffusion of RF across embryonic day 18 chick corneal epithelium ex vivo was monitored using confocal microscopy. The depth distributions of RF in the corneal stroma were calculated using a group of linear equations based on the relationship between RF fluorescence intensity and concentration.RESULTS. Data presented in this study demonstrate that the NC-1059 peptide can transiently open the intact epithelial barrier to allow the permeation of RF into the stroma. The effect of NC-1059 peptide on RF diffusion across the corneal epithelium was concentration and time dependent. The amount of RF reaching a 50-lm depth of chick corneal stoma increased dramatically after exposure to NC-1059 for 10 minutes, reaching a plateau by 30 minutes. The concentrations of RF in the presence of NC-1059 at corneal stromal depths of 50, 100, and 150 lm were significantly higher than in the absence of the peptide, and almost as high as in corneas in which the epithelium first had been physically removed. In addition, a cell viability assay indicated that the NC-1059 peptide did not kill corneal epithelial cells.CONCLUSIONS. NC-1059 peptide significantly enhances the diffusion of RF across intact corneal epithelium into the stroma. (Invest Ophthalmol Vis Sci.

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Riboflavin Osmolar Modification for Transepithelial Corneal Cross-Linking

Abstract: The transepithelial riboflavin solution should contain no dextran, but it should include 0.01% BAC and 0.44% NaCl to promote the permeability of riboflavin through the epithelium, resulting in a sufficient concentration of riboflavin in the corneal stroma.

Cited by 82 publications

References 32 publications

Corneal Collagen Crosslinking: A Systematic Review

Corneal Collagen Crosslinking: A Systematic Review

Corneal Collagen Crosslinking with Riboflavin and Ultraviolet - A Irradiation in the Management of Progressive Ectatic Corneal Disorders. Review Article

Effect of the Synthetic NC-1059 Peptide on Diffusion of Riboflavin across an Intact Corneal Epithelium

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