School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
School of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Transl Vis Sci Technol. 2023 Feb 1;12(2):12. doi: 10.1167/tvst.12.2.12.
To determine whether high-fluence photoactivated chromophore for keratitis cross-linking (PACK-CXL) can be accelerated.
Solutions of Staphylococcus aureus and Pseudomonas aeruginosa with 0.1% riboflavin were prepared and exposed to 365 nm ultraviolet (UV)-A irradiation of intensities and fluences from 9 to 30 mW/cm2 and from 5.4 to 15.0 J/cm2, respectively, representing nine different accelerated PACK-CXL protocols. Irradiated solutions and unirradiated controls were diluted, plated, and inoculated on agar plates so that the bacterial killing ratios (BKR) could be calculated. Additionally, strains of Achromobacter xylosoxidans, Staphylococcus epidermidis, and Stenotrophomonas maltophilia were exposed to a single accelerated PACK-CXL protocol (intensity: 30 mW/cm2, total fluence: 15.0 J/cm2).
With total fluences of 5.4, 10.0, and 15.0 J/cm2, the range of mean BKR for S. aureus was 45.78% to 50.91%, 84.13% to 88.16%, and 97.50% to 99.90%, respectively; the mean BKR for P. aeruginosa was 69.09% to 70.86%, 75.37% to 77.93%, and 82.27% to 91.44%, respectively. The mean BKR was 41.97% for A. xylosoxidans, 65.38% for S. epidermidis, and 78.04% for S. maltophilia for the accelerated PACK-CXL protocol (30 mW/cm2, 15 J/cm2).
The BKR of high-fluence PACK-CXL protocols can be accelerated while maintaining a high, but species-dependent, BKR. The Bunsen to Roscoe law is respected in fluences up to 10 J/cm2 in S. aureus and P. aeruginosa, whereas fluences above 10 J/cm2 show strain dependence.
The high-fluence PACK-CXL protocols can be accelerated in clinical practice while maintaining high levels of BKR.
确定是否可以加速高剂量光激活角膜交联用色原（PACK-CXL）。
制备含 0.1%核黄素的金黄色葡萄球菌和铜绿假单胞菌溶液，分别用 365nm 紫外（UV）-A 照射强度和剂量为 9 至 30mW/cm2 和 5.4 至 15.0J/cm2，分别代表 9 种不同的加速 PACK-CXL 方案。照射后的溶液和未照射的对照溶液进行稀释、平板接种，计算细菌杀灭率（BKR）。此外，还将阿克曼氏菌、表皮葡萄球菌和嗜麦芽窄食单胞菌暴露于一种加速的 PACK-CXL 方案（强度：30mW/cm2，总剂量：15.0J/cm2）。
对于金黄色葡萄球菌，总剂量为 5.4、10.0 和 15.0J/cm2 时，平均 BKR 的范围分别为 45.78%至 50.91%、84.13%至 88.16%和 97.50%至 99.90%；铜绿假单胞菌的平均 BKR 分别为 69.09%至 70.86%、75.37%至 77.93%和 82.27%至 91.44%。对于加速的 PACK-CXL 方案（30mW/cm2，15J/cm2），阿克曼氏菌的平均 BKR 为 41.97%，表皮葡萄球菌为 65.38%，嗜麦芽窄食单胞菌为 78.04%。在金黄色葡萄球菌和铜绿假单胞菌中，Bunsen-Roscoe 定律在 10J/cm2 以下的剂量范围内得到尊重，而超过 10J/cm2 的剂量则表现出菌株依赖性。
在保持高但具有物种依赖性的 BKR 的同时，可以加速高剂量 PACK-CXL 方案。在 10J/cm2 以下的剂量范围内，Bunsen-Roscoe 定律适用于金黄色葡萄球菌和铜绿假单胞菌，而超过 10J/cm2 的剂量则表现出菌株依赖性。
陈梦圆
