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LASIK Ex Vivo术后体外角膜交联(CXL)界面结合

Seiler, T.G., Engler, M., Beck, E., Birngruber, R., Kochevar, I.E.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第14期

关键词:
交联 角膜 界面

摘要

摘要:目的:旨在采用两种不同的光敏剂进行LASIK手术后体外角膜交联(CXL)界面结合研究。方法:采用飞秒激光在兔眼中制作LASIK皮瓣。解剖后,通过CXL来封闭界面。在一组中,使用玫瑰红和绿光进行CXL,而在另一组中使用核黄素和UV-A光。两个组的辐照度,辐射曝光,染色剂浓度和浸润时间是变化的。在对照组中,仅进行LASIK手术。在手术后,测量分离瓣膜与基质所需的最大剪切力。结果:孟加拉红/绿光键合的最佳参数导致剪切力比未处理的对照眼增加2.1倍(P <0.01)。最佳参数组合为:180 mW / cm2的辐照度14分钟(总辐射量为150 J / cm2),孟加拉玫瑰浓度为0.1%,浸润时间为2分钟。优化的核黄素/ UV-A光参数在0.5分钟内持续2分钟,辐照度为30mW / cm2,照射时间为4.5分钟,辐射量为8.1J / cm2。与未经处理的对照眼相比,这些优化的参数增加2倍(P <0.01)。光学透射实验提示后部结构更安全。结论:基于体外结果,LASIK手术后使用玫瑰红或核黄素交联界面结合增加了皮瓣与基质床之间的粘附。需要进行体内试验来评估效应的时间变化。

Purpose:Interface bonding with corneal crosslinking (CXL) after LASIK using two different photosensitizers was studied ex vivo.Methods:A LASIK flap was created in enucleated rabbit eyes using a femtosecond laser. After the dissection, CXL was performed to seal the interface. In one group interface CXL was performed using rose bengal and green light, whereas in a second group riboflavin and UV-A light was used. In both groups irradiance, radiant exposure, dye concentration, and imbibition time was varied. In a control group, LASIK only was performed. After the procedures, the maximal shear-force required to separate the flap from the stroma was measured. Additionally, corneal transmission spectra were recorded.Results:Optimized parameters for rose bengal/green-light bonding lead to a 2.1-fold increase in shear-force compared with untreated control eyes (P < 0.01). The optimal parameter combination was: irradiance of 180 mW/cm2 for 14 minutes (total radiant exposure 150 J/cm2), rose bengal concentration 0.1%, and an imbibition time of 2 minutes. Optimized riboflavin/UV-A light parameters were 0.5% for 2 minutes with a radiant exposure of 8.1 J/cm2 obtained by an irradiance of 30 mW/cm2 for 4.5 minutes. These optimized parameters lead to a 2-fold increase compared with untreated control eyes (P < 0.01). Optical transmission experiments suggest safety for more posterior structures.Conclusions:Based on ex-vivo results, interface bonding after LASIK using crosslinking with either rose bengal or riboflavin increases the adhesion between flap and stromal bed. In vivo trials are needed to evaluate the temporal evolution of the effect.


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