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Frederik Raiskup, Eberhard Spoerl, Lutz E. Pillunat, Roberto Pinelli; Riboflavin Osmolar Modification For Transepithelial Corneal Cross-linking. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5203.
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To investigate the influence of osmolarity on the transepithelial permeability of riboflavin solutions in a cross-linking (CXL) procedure
Several 0.1% riboflavin solutions that contained different NaCl and BAC (benzalkonium chloride) concentrations were applied to 36 rabbit eyes for 30 minutes. To serve as a control, the epithelium was removed in group A. The groups then received the following solutions: (A) hypoosmolar (0.9% NaCl) riboflavin; (B) osmotic (0.44% NaCl) riboflavin with BAC 0.02%; (C) osmotic (0.44% NaCl) riboflavin with BAC 0.01%; (D) osmotic (0.44% NaCl) riboflavin solution without BAC; (E) hypoosmolar (0.9% NaCl) riboflavin with BAC 0.02%; and (F) hypoosmolar (0.9% NaCl) riboflavin without BAC. There were treated 6 eyes in each group. The absorption coefficients of the corneas were measured to characterize the riboflavin penetration into the cornea.
There is a significant difference in the transepithelial riboflavin penetration of 0.1% riboflavin + 0.02% BAC solutions that contain different NaCl concentrations (0.9% NaCl versus 0.44% NaCl). The absorption coefficients are different by more than a factor of two (P=0.001).
The osmotic gradient is an important factor that regulates tight junctions as a barrier and regulates paracellular conductance. The transepithelial riboflavin solution should contain 0.02% BAC and 0.44% NaCl to promote permeability of riboflavin through the epithelium, resulting in a high concentration of riboflavin in the stroma of cornea.
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