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Ahmad Kheirkhah, Vadrevu K Raju, Pedram Hamrah, Reza Dana; Ultraviolet A/Riboflavin Collagen Cross-linking for Conjunctiva. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Although collagen cross-linking (CXL) is commonly used for the cornea, its effect on conjunctiva is unknown. As CXL increases the resistance of the cornea to enzymatic digestion, we hypothesized that the same effect will happen in CXL of the conjunctiva. Therefore, we aim to evaluate the effect of CXL with ultraviolet A (UV-A) and riboflavin on resistance of conjunctiva to enzymatic digestion.
Rabbit eyes were divided in 4 groups and each group received one the following treatments: subconjunctival injection of 0.1% riboflavin followed by irradiation with UV-A (365 nm, 3 mW/cm2) for 30 minutes to the conjunctiva (CXL Group), UV-A irradiation alone for 30 minutes to the conjunctiva (UV Group), subconjunctival injection of riboflavin alone (Riboflavin Group), or no treatment (Control Group). After treatment, the same size of conjunctival tissue for all groups was immediately excised and exposed to collagenase enzyme. The time to complete digestion of the conjunctiva was recorded for each group.
Mean digestion time for conjunctiva was significantly higher in the CXL Group (48.7 ± 6.5 hours) compared to UV Group (24.1 ± 6.2 hours), Riboflavin Group (26.0 ± 5.1 hours), and Control Group (25.3 ± 4.0 hours) with all P<0.05.
CXL using UV-A and riboflavin significantly increases the resistance of the conjunctiva to collagen-digesting enzymes. This CXL-induced increased resistance of the conjunctiva to digesting enzyme might be useful in patients with conjunctivochalasis (redundant conjunctival folds) or thin blebs after glaucoma surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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