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标准与加速核黄素-紫外线角膜胶原交联:抗酶消化能力

Standard versus accelerated riboflavin-ultraviolet corneal collagen crosslinking: Resistance against enzymatic digestion.

作者信息

Aldahlawi Nada H, Hayes Sally, O'Brart David P S, Meek Keith M

机构信息

From the Structural Biophysics Research Group (Aldahlawi, Hayes, Meek), School of Optometry and Vision Sciences, Cardiff University, Cardiff, and the Keratoconus Research Institute (O'Brart), Department of Ophthalmology, St Thomas Hospital, London, United Kingdom.

From the Structural Biophysics Research Group (Aldahlawi, Hayes, Meek), School of Optometry and Vision Sciences, Cardiff University, Cardiff, and the Keratoconus Research Institute (O'Brart), Department of Ophthalmology, St Thomas Hospital, London, United Kingdom.

出版信息

J Cataract Refract Surg. 2015 Sep;41(9):1989-96. doi: 10.1016/j.jcrs.2015.10.004.

Abstract

PURPOSE

To examine the effect of standard and accelerated corneal collagen crosslinking (CXL) on corneal enzymatic resistance.

SETTING

School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom.

DESIGN

Experimental study.

METHODS

Sixty-six enucleated porcine eyes (with corneal epithelium removed) were assigned to 6 groups. Group 1 remained untreated, group 2 received dextran eyedrops, and groups 3 to 6 received riboflavin/dextran eyedrops. Group 4 had standard CXL (3 mW/cm(2) ultraviolet-A for 30 minutes), whereas groups 5 and 6 received accelerated CXL (9 mW/cm(2) for 10 minutes and 18 mW/cm(2) for 5 minutes, respectively). Trephined central 8.0 mm buttons from each cornea underwent pepsin digestion. Corneal diameter was measured daily, and the dry weight of 5 samples from each group was recorded after 12 days of digestion.

RESULTS

All CXL groups (4 to 6) took longer to digest and had a greater dry weight at 12 days (P < .0001) than the nonirradiated groups (1 to 3) (P < .0001). The time taken for complete digestion to occur did not differ between the standard and accelerated CXL groups, but the dry weights at 12 days showed significant differences between treatments: standard CXL 3 mW > accelerated CXL 9 mW > accelerated CXL 18 mW (P < .0001).

CONCLUSIONS

Standard and accelerated CXL both increased corneal enzymatic resistance; however, the amount of CXL might be less when accelerated CXL is used. The precise amount of CXL needed to prevent disease progression is not yet known.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

研究标准和加速角膜胶原交联(CXL)对角膜酶抗性的影响。

设置

英国加的夫卡迪夫大学验光与视觉科学学院。

设计

实验研究。

方法

66只摘除的猪眼(去除角膜上皮)被分为6组。第1组未接受治疗,第2组接受右旋糖酐滴眼液,第3至6组接受核黄素/右旋糖酐滴眼液。第4组进行标准CXL(3 mW/cm²紫外线A照射30分钟),而第5组和第6组接受加速CXL(分别为9 mW/cm²照射10分钟和18 mW/cm²照射5分钟)。从每个角膜切下的中心8.0 mm纽扣状组织进行胃蛋白酶消化。每天测量角膜直径,消化12天后记录每组5个样本的干重。

结果

所有CXL组(4至6组)消化所需时间比未照射组(1至3组)更长,且在12天时干重更大(P <.0001)。标准和加速CXL组之间完全消化所需时间无差异,但12天时的干重在不同治疗组之间存在显著差异:标准CXL 3 mW >加速CXL 9 mW >加速CXL 18 mW(P <.0001)。

结论

标准和加速CXL均增加了角膜酶抗性;然而,使用加速CXL时CXL的量可能较少。预防疾病进展所需的精确CXL量尚不清楚。

财务披露

没有作者对文中提及的任何材料或方法拥有财务或专利权益。

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