Сollagen cross-linking: new opportunities in treatment of corneal diseases

Novikov, Sergey A.; Александрович, Новиков Сергей; Захарова, О. А.; Александровна, Захарова Ольга; Zhabrunova, Mariya Aleksandrovna; Александровна, Жабрунова Мария; Beldovskaya, Nataliya Yuryevna; Юрьевна, Белдовская Наталия; Onishchenko, Yekaterina Sergeyevna; Сергеевна, Онищенко Екатерина

doi:10.17816/ov2014250-59

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Экзогенными факторами развития язв роговицы являются травматическая патология, перенесенный герпетический кератит, кератомикозы, ССГ, эрозия роговицы, осложнения хирургических вмешательств (кераторефракционные и реконструктивные операции), нарушение режима ношения мягких контактных линз и др. [2][3][4][5][6][7][8][9]. К эндогенным факторам следует отнести наличие хронических очагов инфекции в организме, иммунодефицитные состояния, системные заболевания, ведущие к трофическим расстройствам в роговице [1,7].…”

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A Differentiated Approach to the Complex Treatment of Cornea Ulcers

2018

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Ulcerative lesions of the cornea in 17–21 % lead to functional and up to 8 % to anatomical death of the eye depending on the severity. The aim of the work was to develop an algorithm of surgical treatment of patients with corneal ulcers. Comprehensive examination, treatment and outcomes in the dynamics of ulcerative lesions was performed in 126 patients, 86 patients of them received surgical intervention (with the threat of corneal perforation or present) for emergency indications and in 40 cases combined treatment was carried out with the use of a crosslinking (CRL) in corneal ulcer and ulcer a corneal transplant. Surgical intervention included autoconjuctival plasty (AUC), the transplantation of amniotic membrane in combination with blepharorrhaphy (TAM + BR), lamellar keratoplasty (PKP), penetrating keratoplasty (PK), reconstructive keratoplasty (RCP). The most favorable outcomes with relief of inflammation were achieved in RCP and PC. In cases of delayed epithelialization of the cornea and graft (herpesvirus infection and trophic disorders), the most resonant ones were TAM and TAM + BR. CRL treatment was carried out in 3 variants: 1-as the main method of treatment, 2 — CRL in combination with TAM + BR, 3 — CRL + keratoplasty ( 5–7 days after surgery). As a treatment result, epithelialization of ulcerative-destructive process and partial increase in visual acuity were observed in all patients. Based on the results of patient’s treatment the algorithm of complex surgical care was created. It takes into account the etiology, localization, depth and severity of the inflammatory process, the area of ulcerative lesions of the cornea and of the graft, reduced terms of treatment inflammation and rehabilitation period.

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Section: Introductionunclassified

A Differentiated Approach to the Complex Treatment of Cornea Ulcers

2018

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Corneal collagen cross-linking in mixed etiology keratitis treatment: a case of successful use

Khripun¹,

Владимирович²,

Kobinets

et al. 2021

Ophthalmology Reports

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Acanthamoeba keratitis with bacterial, fungal superinfection or without it leads to development of an aggressive and long-standing corneal inflammation; up to now, the efficacy of its treatment stays doubtful and demands further investigation. For a long time, there were discussions on the possibility and expediency of corneal collagen cross-linking (PACK-CXL photo activated chromophore for keratitis) in patients with bacterial, fungal and Acanthamoeba keratitis. This article presents a clinical case of effective treatment of mixed etiology keratitis by multiple high fluence accelerated PACK-CXL in a patient with severe local toxico-allergic reaction.

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Crosslinking of the Bioplast plastic material as a means of increasing its biomechanical stability and the effectiveness of keratoplasty for corneal ulcers

Somidin

Chentsova

Iomdina

2021

Rossijskij oftalʹmologičeskij žurnal

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Purpose:to assess the effect of ultraviolet (UVA) crosslinking of Bioplast plastic material (silicon-dried human cornea) on its biomechanical stability and effectiveness for keratoplasty in corneal ulcers. Material and methods. To determine the maximum rehydration time, 12 Bioplast samples were incubated in physiological solution (NaCl 0.9 %) for 12 hours and monitored for thickness using optical coherence tomography (OCT Spectralis, Heidelberg Engineering). After the epithelium was scarified rehydrated corneas were treated withof 0.1% riboflavin solution for 30 minutes, and after it 8 rehydrated samples (experimental group) were treated with UVA for 30minutes (wavelength 370 nm, power 3 mW/cm2) using a UV-X device system (IROC AG, Switzerland). In the control group (4 rehydrated samples), no UVA crosslinking was performed. The elastic-strength indicators of the experimental and control group samples were assessed by applying uniaxial tension using a deformation machine (Autograph AGS-H, Japan). To examine the patients (presented in clinical examples)before and after keratoplasty with Bioplast subjected to UVA crosslinking, a set of standard ophthalmic tests was used. Results.Rehydration of Bioplast was the most intensive in the first three hours of incubation, during which time tissue thickness increased uniformly by 50–55 μm/hour to 700–710 μm, while further incubation showed no significant additional effect on the fluid content in the cornea. After UVA crosslinking, the strength indices and the elastic modulus of the rehydrated Bioplast samples significantly increased in comparison with the control group. Clinical examples demonstrate the effectiveness of modified Bioplast for organ-preserving penetrating keratoplasty in case of perforatedcorneal ulcer. Conclusion. UVA crosslinking of rehydrated Bioplast increases its biomechanical stability. The data of laboratory studies and the first clinical tests demonstrate that modified Bioplast may be an effective replacement of native donor cornea in urgent keratoplasty of perforated ulcers.

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Сollagen cross-linking: new opportunities in treatment of corneal diseases

Cited by 3 publications

References 23 publications

A Differentiated Approach to the Complex Treatment of Cornea Ulcers

A Differentiated Approach to the Complex Treatment of Cornea Ulcers

Corneal collagen cross-linking in mixed etiology keratitis treatment: a case of successful use

Crosslinking of the Bioplast plastic material as a means of increasing its biomechanical stability and the effectiveness of keratoplasty for corneal ulcers

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