Riboflavin and Ultraviolet A Collagen Crosslinking of the Cornea for the Treatment of Keratitis

Morén, Håkan; Malmsjö, Malin; Mortensen, Jes; Öhrström, Arne

doi:10.1097/ico.0b013e31819c4e43

Cited by 109 publications

(77 citation statements)

References 8 publications

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“…Moreover, Micelli-Ferrari et al (MicelliFerrari et al, 2009) described a case of keratitis caused by the Gram-negative Escherichia coli treated with CXL with outstanding outcome. Similar results were also reported by More´n et al (More´n et al, 2010), who treated an infectious keratitis using CXL.…”

Section: Corneal Collagen Cross-linking In Infectious Keratitissupporting

confidence: 90%

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

Kozobolis¹,

Gkika²,

Labiris³

2012

Keratitis

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Section: Corneal Collagen Cross-linking In Infectious Keratitissupporting

confidence: 90%

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

Kozobolis¹,

Gkika²,

Labiris³

2012

Keratitis

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“…Recently, scientists have examined treatment with riboflavin and ultraviolet A light (UVA) in cases of severe infectious keratitis [140,[148][149][150][151]. The mechanism by which this process is thought to work is via collagen crosslinking.…”

Section: Infectious Keratitismentioning

confidence: 99%

The Role of Ultraviolet Radiation in the Ocular System of Mammals

et al. 2014

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Abstract:With decreasing levels of ozone in the atmosphere, we are being exposed to higher levels of ultraviolet radiation (UVR) than ever before. UVR carries higher energy than visible light, and its effects on tissues include DNA damage, gene mutations, immunosuppression, oxidative stress and inflammatory responses. In the eye, UVR is strongly associated with the development of basal and squamous cell carcinoma of the eyelid, pterygium, photokeratitis, climatic droplet keratopathy, ocular surface squamous neoplasia, cataracts, and uveal melanoma, and is weakly associated with age-related macular degeneration. Despite overwhelming evidence regarding the deleterious effects on UVR, public health measures to encourage UV protection of the eyes is generally lacking. Options for photoprotection include sunglasses, wide brim hats, windshields, plastic films for side windows in cars, UV blocking contact lenses, and following the UV Index report daily. The American National Standards Institute currently has regulations regarding properties of UV blocking sunglasses; however, compliance in the US is not mandatory. On the other hand, UVR does have therapeutic applications in the eye, particularly, riboflavin activated by ultraviolet A light (UVA) radiation is used clinically to slow the progression of keratoconus, post-LASIK keratectasia, and bullous keratopathy by crosslinking corneal collagen fibers. OPEN ACCESSPhotonics 2014, 1 348 Additionally, riboflavin activated by UVA has been shown to have antibacterial, antiviral, and antiparasitic effects. This is clinically relevant in the treatment of infectious keratitis. Finally, exposure to low levels of light in the UV spectrum has been found to regulate the growth of the eye and lack of adequate exposure may increase the risk of development and progression of myopia.

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“…Studies show that therapeutic transplants represent 2.6% to 17.9% of total penetrating transplants (17) . There are reports of corneal ulcers treated successfully with corneal collagen crosslinking (CXL) (18)(19)(20)(21)(22)(23)(24)(25) . An experimental study found increased resistance to enzymatic digestion by collagenase, pepsin, and trypsin in corneas subjected to CXL (26) .…”

mentioning

confidence: 99%

“…Currently, CXL is usually indicated for cases of keratoconus (30) , pellucid marginal degeneration (31) , painful bullous keratopathy (32) , and iatrogenic ectasia after refractive surgery with laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) (30) . The therapeutic effects of CXL in infectious keratitis are still unclear (18)(19)(20)(21)(22)(23)(24)(25)(26) . This study aimed to evaluate the effect of CXL on infectious keratitis resistant to medical treatment.…”

mentioning

confidence: 99%

Efeito terapêutico do crosslinking corneal na ceratite infecciosa

Escarião¹,

Ribeiro²,

Jorge³

et al. 2013

Rev. bras.oftalmol.

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Purpose:To evaluate the effect of corneal crosslinking (CXL) RESUMOObjetivo: Avaliar o efeito do crosslinking (CXL) no tratamento de ceratite infecciosa, resistente ao tratamento clínico, e investigar a relação com o agente etiológico. Métodos: Foram incluídos 11 pacientes com diagnóstico de ceratite infecciosa de etiologia bacteriana (sete olhos) e fúngica (quatro olhos) na Fundação Altino Ventura (FAV) no período de outubro de 2011 a maio de 2012. Os pacientes incluídos estavam em uso de colírios há pelo menos sete dias e não apresentavam melhora da infecção. Estes foram avaliados antes da realização do CXL e no período pós-operatório até cicatrização da úlcera. Para realização do CXL foram instiladas gotas de riboflavina a 0,1% e dextrano a 20%, a cada cinco minutos em um período de 30 minutos antes do procedimento, e durante a aplicação da luz ultravioleta A (UVA). A córnea foi exposta à UVA com comprimento de onda de 370ηm ± 5ηm e uma irradiância de 3mW/cm². Resultados: Os pacientes com infecção bacteriana obtiveram cura do processo infeccioso após o CXL e nenhum paciente com ceratite fúngica apresentou cicatrização. Observou-se associação significante (p = 0,003) entre o agente etiológico e a cicatrização. Conclusão: O CXL mostrou-se eficaz no tratamento da ceratite bacteriana resistente ao tratamento clínico, evitando a realização de transplante tectônico. Em relação à ceratite fúngica, este procedimento não influenciou na melhora do processo infeccioso.Descritores: Córnea; Reagentes para ligações cruzadas/uso terapêutico; Ceratite infecciosa/quimioterapia; Ceratite bacteriana/ quimioterapia; Ceratite fúngica/quimioterapia

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Riboflavin and Ultraviolet A Collagen Crosslinking of the Cornea for the Treatment of Keratitis

Cited by 109 publications

References 8 publications

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

Corneal Collagen Cross-Linking Using Riboflavin and Ultraviolet-A Irradiation in Keratitis Treatment

The Role of Ultraviolet Radiation in the Ocular System of Mammals

Efeito terapêutico do crosslinking corneal na ceratite infecciosa

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