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Increased Resistance of Collagen-linked Cornea against Enzymatic Treatment

Spörl E., Wollensak G., Seiler T., Pillunat L. E.,
Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Augenheilkunde (Dresden)

Purpose: Collagen-crosslinking with riboflavin + UVA for mechanical stabilization of keratoconus and corneal ulcers has been carried out in Dresden for four years. The purpose of the present study was to investigate the influence of this treatment on the resistance of corneal collagen against enzymatic digestion.
Methods: Three different treatment groups with 5 enucleated porcine eyes were chosen: 1. group I: ultraviolet light (370 nm, 3 mW/cm² for 30 min) + riboflavin; 2. group II: ultraviolet light (370 nm, 2 mW/cm² for 30 min) + riboflavin; 3. control group: without irradiation and riboflavin. After treatment, corneal buttons with 10 mm diameter were trephined and incubated in pepsin solution (2g pepsin in 10 ml 0.1m HCl). The degree of the enzymatic digestion of the cornea was determined using the change of the button diameter over time.
Results: The uncrosslinked corneal buttons of the control group were totally resolved after the 4th day. Buttons irradiated with 3mW/cm² of group I were resolved at the 10th day and bottons irradiated with 2 mW/cm² at the 8th day.
Conclusions: Photochemical crosslinking of the cornea by riboflavin and ultraviolet light leads to an increase of resistance against collagen digestion enzymes. In addition to the already known mechanical stabilization, this effect should contribute to the treatment of corneal ulcers.

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