UV-A Collagen Cross-Linking Treatment of Bullous Keratopathy Combined With Corneal Ulcer

Kozobolis, Vassilios; Labiris, Georgios; Gkika, Maria; Sideroudi, Harris; Kaloghianni, Eleni; Papadopoulou, Dorris; Toufexis, George

doi:10.1097/ico.0b013e3181a81802

Cited by 56 publications

(46 citation statements)

References 20 publications

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“…In vitro experiments have supported the view that there is a bactericidal effect of activated riboflavin by using 365-nm UV light [138,139]. When activated by UV light 365-370 nm, riboflavin acts as a photosensitizer in tissues and becomes a generator of reactive oxygen species, creating free radicals to induce new chemical bonds [140][141][142][143][144][145][146]. The aim of treatment with UVA and riboflavin is to create additional chemical bonds inside the cornea in the anterior stroma while minimizing exposure to the surrounding structures of the eye; free radicals generated by this process can cause oxidative damage to DNA and RNA molecules in the surrounding structures [146,147].…”

Section: Antimicrobial Effectmentioning

confidence: 72%

The Role of Ultraviolet Radiation in the Ocular System of Mammals

et al. 2014

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Abstract:With decreasing levels of ozone in the atmosphere, we are being exposed to higher levels of ultraviolet radiation (UVR) than ever before. UVR carries higher energy than visible light, and its effects on tissues include DNA damage, gene mutations, immunosuppression, oxidative stress and inflammatory responses. In the eye, UVR is strongly associated with the development of basal and squamous cell carcinoma of the eyelid, pterygium, photokeratitis, climatic droplet keratopathy, ocular surface squamous neoplasia, cataracts, and uveal melanoma, and is weakly associated with age-related macular degeneration. Despite overwhelming evidence regarding the deleterious effects on UVR, public health measures to encourage UV protection of the eyes is generally lacking. Options for photoprotection include sunglasses, wide brim hats, windshields, plastic films for side windows in cars, UV blocking contact lenses, and following the UV Index report daily. The American National Standards Institute currently has regulations regarding properties of UV blocking sunglasses; however, compliance in the US is not mandatory. On the other hand, UVR does have therapeutic applications in the eye, particularly, riboflavin activated by ultraviolet A light (UVA) radiation is used clinically to slow the progression of keratoconus, post-LASIK keratectasia, and bullous keratopathy by crosslinking corneal collagen fibers. OPEN ACCESSPhotonics 2014, 1 348 Additionally, riboflavin activated by UVA has been shown to have antibacterial, antiviral, and antiparasitic effects. This is clinically relevant in the treatment of infectious keratitis. Finally, exposure to low levels of light in the UV spectrum has been found to regulate the growth of the eye and lack of adequate exposure may increase the risk of development and progression of myopia.

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Section: Antimicrobial Effectmentioning

confidence: 72%

The Role of Ultraviolet Radiation in the Ocular System of Mammals

et al. 2014

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“…CXL's antimicrobial and anti-oedematous properties were demonstrated by (Kozobolis et al, 2010) in our report of two patients with combined bullous keratopathy and ulcerative keratitis, resistant to conventional treatments. Former investigators suggested that corneal cross-linking (CXL) might have beneficial impact against corneal melting from bacterial and fungal enzymes, because of the antimicrobial effect of UV-A radiation per se .…”

Section: Corneal Collagen Cross-linking In Complicated Bullous Keratomentioning

confidence: 92%

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

Kozobolis¹,

Gkika²,

Labiris³

2012

Keratitis

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“…Corneal collagen cross-linking in complicated bullous keratopathy with ulcerative keratitis CXL's antimicrobial and anti-oedematous properties were demonstrated by Kozobolis et al [62] in their report of two patients with combined bullous keratopathy and ulcerative keratitis, resistant to conventional treatments. Both patients presented significant improvement of their vision-threatening corneal ulcer, corneal oedema and BCVA for a follow-up period of 2 months.…”

Section: Corneal Collagen Cross-linking In Infectious Keratitismentioning

confidence: 93%

Corneal collagen cross-linking using riboflavin and ultraviolet-A irradiation: a review of clinical and experimental studies

2011

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Corneal collagen cross-linking (CXL) using riboflavin and ultraviolet-A irradiation is a common method of tissue stabilization and has been developed primarily to address the need of treating keratoconus. CXL's promising results on keratoconus indicated that it might be effective in other corneal diseases as well. This new treatment promises a slowing effect on the progression of these diseases and its initial results show that it is safe and reasonably curative. The purpose of this review is to critically evaluate this treatment, to explore its benefits, to highlight its limitations in terms of efficacy and long-term safety and finally to identify areas for future research in this topic with a significant potential to change the way we treat our patients. In addition, in this unbiased review we try to bring together all the scientific information from both laboratory and clinical trials that have been conducted during recent years and to review the most recent publications regarding the therapeutic indications of CXL.

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UV-A Collagen Cross-Linking Treatment of Bullous Keratopathy Combined With Corneal Ulcer

Abstract: CXL should be considered as a potential adjuvant therapeutic tool in patients with combined bullous keratopathy and infectious keratitis, who are resistant to traditional topical therapy.

Cited by 56 publications

References 20 publications

The Role of Ultraviolet Radiation in the Ocular System of Mammals

The Role of Ultraviolet Radiation in the Ocular System of Mammals

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

Corneal collagen cross-linking using riboflavin and ultraviolet-A irradiation: a review of clinical and experimental studies

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