Spiess Bernhard M, Pot Simon A, Florin Marion, Hafezi Farhad
Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland.
Vet Ophthalmol. 2014 Jan;17(1):1-11. doi: 10.1111/vop.12027. Epub 2013 Jan 29.
UV-A/riboflavin cross-linking (CXL) of corneal collagen fibers is an established, highly promising therapy for corneal melting in physician-based ophthalmology. A prospective pilot study was conducted to demonstrate proof of principle of this novel method for the treatment of melting corneal ulcers in dogs and cats.
After obtaining owner consent, CXL was performed in three cats and three dogs with corneal melting, which either affected the entire corneal surface or was resistant to conventional antibiotic and anticollagenolytic therapy, and affected parts or all of the corneal surface. Medical therapy was continued in all patients. The available follow-up ranged from 2 to 22.5 months and involved slit-lamp examination, fluorescein staining, and photographic documentation during all rechecks.
Surgical stabilization of the cornea was not necessary in any case, because progression of corneal melting was arrested in all cases within 1-20 days of CXL treatment. Corneal re-epithelization occurred within 7-40 days in all eyes. At 40 days after CXL, all eyes presented a quiescent corneal state without signs of active inflammation and with beginning scar formation. The complications observed in three of the six animals included a corneal sequestrum, superficial corneal stromal pigmentation, and bullous keratopathy.
This study shows the feasibility of CXL to treat progressive corneal melting in veterinary patients. CXL may represent a cost-efficient and safe alternative therapy in the treatment for corneal melting in veterinary ophthalmology. More investigations comparing the effectivity and complication rate of CXL to those of standard medical treatment are necessary.
角膜胶原纤维的紫外线A/核黄素交联（CXL）是一种成熟且前景广阔的治疗方法，用于基于医生的眼科中的角膜溶解。进行了一项前瞻性试点研究，以证明这种治疗犬猫角膜溃疡的新方法的原理。
在获得主人同意后，对三只患有角膜溶解的猫和三只狗进行了CXL治疗，这些角膜溶解要么影响整个角膜表面，要么对传统抗生素和抗胶原溶解治疗有抗性，并且影响部分或全部角膜表面。所有患者均继续进行药物治疗。可用的随访时间为2至22.5个月，所有复查均包括裂隙灯检查、荧光素染色和摄影记录。
在任何情况下都无需进行角膜手术稳定，因为在CXL治疗的1至20天内，所有病例的角膜溶解进展均停止。所有眼睛在7至40天内角膜重新上皮化。CXL后40天，所有眼睛均呈现角膜静止状态，无活动性炎症迹象，且开始形成瘢痕。在六只动物中的三只中观察到的并发症包括角膜腐骨、角膜浅层基质色素沉着和大疱性角膜病变。
本研究表明CXL治疗兽医患者进行性角膜溶解的可行性。CXL可能是兽医眼科治疗角膜溶解的一种经济高效且安全的替代疗法。有必要进行更多研究，比较CXL与标准药物治疗的有效性和并发症发生率。
