flavin-mononucleotide and Corneal-Edema

Topics: Analysis of Variance; Animals; Collagen; Corneal Edema; Corneal Stroma; Cross-Linking Reagents; Flavin Mononucleotide; Humans; Swine; Ultraviolet Rays; Vitamin B Complex

We evaluated whether UVA-riboflavin collagen cross-linking (CXL) reduces stromal swelling pressure (SP) in porcine and human corneas ex vivo.. Porcine corneas (N = 35) were divided into five groups: Full-thickness buttons, riboflavin-treated buttons, CXL-treated buttons, riboflavin-treated anterior and posterior lamellae, and CXL-treated anterior and posterior lamellae. Riboflavin- or CXL-treated human corneas (n = 6) were cut into anterior and posterior lamellae. The force exerted by the specimens during swelling in saline was recorded and SP was calculated. Dry weights were obtained for solids correction.. In full-thickness porcine buttons, a significantly reduced SP was observed after CXL (40.07 ± 3.86 mm Hg) compared to riboflavin treatment (68.13 ± 11.39 mm Hg, P = 0.02) at 5% compression. Also, a trend toward reduced SP in the CXL-treated anterior human lamellae (9.9 mm Hg) was found compared to the riboflavin group (25 mm Hg) at 5% compression. In the anterior porcine lamellae a significant SP reduction was observed in the CXL group versus the riboflavin group (P < 0.001, two-way ANOVA). Likewise, in the posterior porcine lamellae, a significant SP reduction was observed in the CXL group versus riboflavin alone (P < 0.05, two-way ANOVA). Posterior human lamellae did not differ in SP when comparing CXL and riboflavin groups.. Our study demonstrated a significant reduction in anterior stromal SP in porcine and human corneas after CXL. This finding suggested that CXL may reduce corneal SP in vivo, and thereby reduce edema and improve vision. Thus, in the clinical setting, patients suffering from corneal edema may benefit from CXL treatment.

Topics: Analysis of Variance; Animals; Collagen; Corneal Edema; Corneal Stroma; Cross-Linking Reagents; Endothelium, Corneal; Flavin Mononucleotide; Humans; Swine; Ultraviolet Rays; Vitamin B Complex

The aim of the present study was to investigate the characteristic honeycomb hydration pattern after corneal cross linking using in vivo rabbit cornea.. After removal of the central epithelium, the right corneas of 4 New Zealand white rabbits were cross-linked applying a photosensitizing 0.1% riboflavin-dextran solution and UV-A light of 370 nm wavelength with a surface irradiance of 3 mW/cm for 30 minutes. Two animals were euthanized 3 days postoperatively and another 2 were euthanized 6 weeks postoperatively. The corneas of the enucleated eyes were evaluated using 4-mum light microscopic sections with tangential en face and cross-sectional orientation.. By day 3 after treatment, complete apoptotic damage and loss of the stromal keratocytes and endothelial cells were found in the central irradiated area through the entire thickness of the stroma. There was marked lacunar edema in the former positions of the apoptotic keratocytes in the anterior 250 microm of the stroma and diffuse edema in the adjacent posterior and lateral zones. Lacunar edema was identified best on tangential sections. By week 6, the cytoarchitecture of the cornea appeared normal again, and complete resolution of both lacunar and diffuse corneal edema had occurred.. After riboflavin/UV-A cross linking of in vivo rabbit cornea, a characteristic lacunar hydration pattern can be observed in the anterior stroma with maximum cross linking, whereas diffuse edema is present in the adjacent areas without significant cross linking. The lacunar edema may explain the temporary demarcation of the anterior stroma after cross linking on biomicroscopy because of increased light scattering. The network pattern of cross linking may contribute to the elasticity of the cornea after cross linking.

Topics: Animals; Body Water; Collagen; Corneal Edema; Corneal Stroma; Cross-Linking Reagents; Debridement; Elastic Tissue; Female; Flavin Mononucleotide; Photosensitizing Agents; Rabbits; Ultraviolet Rays; Wound Healing