Abstract
Purpose: :
To analyze the influence of corneal crosslinking (CXL) on penetration of topically applied voriconazole.
Methods: :
In an ex-vivo porcine eye model, corneas were crosslinked (group 1, n=27 eyes) performing a corneal abrasion, applying riboflavin 5 mg/ml drops every 5 minutes for 30 minutes and irradiating with UVA (370 nm, 3 mW/cm2 for 30 minutes). Afterwards, eyes were rinsed with balanced salt solution (BSS). Voriconazole eye drops (10mg/ml) were topically applied onto the cornea every 5 minutes for a total of 30 minutes. In a control group (n=27 eyes) corneal abrasion and riboflavin application were performed equally, but without following UVA irradiation. Central corneal thickness and anterior chamber depth were measured using a Pentacam Scheimpflug device. In both groups, anterior chamber taps and voriconazole HPLC analysis from aqueous humor were performed.
Results: :
Concentration of voriconazole in the anterior chamber was significantly lower in the eyes with previous CXL (mean 54.7±9.0 µg/ml) than in the untreated group (mean 62.9±13.0 µg/ml, p=0.01). Corneal thickness and anterior chamber volume were comparable in both groups (p>0.50, each).
Conclusions: :
CXL seems to reduce the penetration of topical applied voriconazole.
Keywords: cornea: basic science • keratoconus • fungal disease