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Xiaokun Wang, Shoumyo Majumdar, Jennifer Elisseeff; Ultrasound-assist penetration of riboflavin with soluble collagen as regulating reagent during UVA crosslinking. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4211.
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The aim of this study is to protect collagen microstructure damage and to enhance riboflavin penetration by inducing the combination of collagen solution and ultrasonic treatment during crosslinking.
Fresh rabbit corneas were treated with riboflavin isotonic solution with or without soluble collagen. The tissues were treated by ultrasound for 0~10 min before UVA crosslinking was performed. During UVA crosslinking, hydration was maintained by adding crosslinking solution periodically. Samples were analyzed by confocal microscope, differential scanning calorimetry and transmission electron microscopy.
Ultrasound treatment was able to promote riboflavin and collagen solution absorption compared to the non-ultrasound treated group. UVA crosslinking increased transition temperature from 72.5±1.52 to 73.4±1.77 after 30 min of UVA irradiation. TEM images showed significant collagen layer condensing and fibril thickening, as well as the formation of inter-fibrillar residues and the damage of collagen banding pattern after crosslinking. The inducing of soluble collagen was able to partially protect the condensing of collagen fibril layers and fibril thickening.
This study shows ultrasound treatment promotes riboflavin, as well as the collagen regulating agent penetration. Collagen fibrils and banding patterns are damaged by UVA irradiation, and soluble collagen regulating agent partially protects the collagen fibril damages and prevent the trend in cornea tissue thinning during crosslinking. This study provides the potential clinical relevance of damage and prevention strategies of collagen crosslinking therapy for keratoconus.
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