细菌叶绿素衍生物与右旋糖酐及近红外光导致的角膜硬化：缩短至1分钟照射时间的效果

Corneal Stiffening by a Bacteriochlorophyll Derivative With Dextran and Near-Infrared Light: Effect of Shortening Irradiation Time up to 1 Minute.

作者信息

Brekelmans Jurriaan, Goz Alexandra, Dickman Mor M, Brandis Alexander, Sui Xiaomeng, Wagner H Daniel, Nuijts Rudy M M A, Scherz Avigdor, Marcovich Arie L

机构信息

*University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; †Department of Plant Sciences and Environmental Health, Weizmann Institute of Science, Rehovot, Israel; ‡Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel; §Department of Biological Services, Weizmann Institute of Science, Rehovot, Israel; and ¶Department of Materials and Interfaces, Weizmann Institute of Science, Rehovot, Israel.

出版信息

Cornea. 2017 Nov;36(11):1395-1401. doi: 10.1097/ICO.0000000000001272.

DOI:10.1097/ICO.0000000000001272

PMID:28644240

Abstract

PURPOSE

The aim of this study is to determine the effect of variation of the exposure time of near-infrared irradiation on corneal stiffening after a bacteriochlorophyll derivative (WST11) with dextran (WST-D) application.

METHODS

One hundred four paired eyes of 3-month-old New Zealand White rabbits were included in this study. Fifty-two eyes (ex vivo n = 34, in vivo n = 18) were mechanically deepithelialized, treated topically with WST-D, and irradiated at 10 mW/cm using a diode laser at 755 nm for 1, 5, or 30 minutes. Untreated fellow eyes served as controls. Corneoscleral rings were removed immediately after treatment (ex vivo), or 1 month after treatment (in vivo). Corneal strips were cut and underwent biomechanical stress-strain measurements.

RESULTS

Ex vivo, the mean tangent elastic modulus was significantly higher in the treatment groups than in the control groups for 1, 5, and 30 minutes of irradiation, respectively, 6.06 MPa, 95% confidence interval (CI, 4.5-7.6) versus 14.02 MPa, 95% CI (10.2-17.8), n = 11, 4.8 MPa, 95% CI (3.9-5.7) versus 15.03 MPa, 95% CI (12-18.1), n = 11, and 7.8 MPa, 95% CI (5.6-10.02) versus 16.2 MPa, 95% CI (13.6-18.9), n = 11; P < 0.001 for all comparisons. In vivo, the mean elastic moduli in the treatment groups were significantly higher for 5 and 30 minutes of irradiation but not for 1 minute of irradiation, respectively, 11.4 MPa, 95% CI (8.5-14.2), versus 17.1 MPa, 95% CI (14.5-19.7), n = 5; P < 0.001, and 9.4 MPa, 95% CI (5.1-13.8) versus 16 MPa, 95% CI (13.1-19), n = 5; P < 0.01, and 11.3 MPa, 95% CI (6-16.6) versus 12.2 MPa, 95% CI (7.5-16.8), n = 5; P = 0.7.

CONCLUSIONS

WST-D/near-infrared treatment using shortened irradiation time (1 minute ex vivo and 5 minutes in vivo) results in significant corneal stiffening, and this might provide an alternative to the currently applied riboflavin/ultraviolet A cross-linking.

摘要

目的

本研究旨在确定在应用细菌叶绿素衍生物（WST11）与葡聚糖（WST-D）后，近红外照射时间变化对角膜硬化的影响。

方法

本研究纳入了104只3月龄新西兰白兔的配对眼。52只眼（离体n = 34，体内n = 18）进行机械性上皮剥除，局部应用WST-D，并使用755 nm二极管激光器以10 mW/cm²的功率照射1、5或30分钟。未治疗的对侧眼作为对照。治疗后立即（离体）或治疗后1个月（体内）取出角膜巩膜环。切割角膜条并进行生物力学应力-应变测量。

结果

离体情况下，照射1分钟、5分钟和30分钟时，治疗组的平均切线弹性模量分别显著高于对照组，6.06 MPa，95%置信区间（CI，4.5 - 7.6）对14.02 MPa，95% CI（10.2 - 17.8），n = 11；4.8 MPa，95% CI（3.9 - 5.7）对15.03 MPa，95% CI（12 - 18.1），n = 11；7.8 MPa，95% CI（5.6 - 10.02）对16.2 MPa，95% CI（13.6 - 18.9），n = 11；所有比较P < 0.001。在体内，照射5分钟和30分钟时治疗组的平均弹性模量显著高于对照组，但照射1分钟时无显著差异，分别为11.4 MPa，95% CI（8.5 - 14.2）对17.1 MPa，95% CI（14.5 - 19.7），n = 5；P < 0.001，以及9.4 MPa，95% CI（5.1 - 13.8）对16 MPa，95% CI（13.1 - 19），n = 5；P < 0.01，和11.3 MPa，95% CI（6 - 16.6）对12.2 MPa，95% CI（7.5 - 16.8），n = 5；P = 0.7。