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Title
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Effect of accelerated high-fluence riboflavin and rose bengal-mediated corneal cross-linking on resistance to enzymatic digestion
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Author
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Abstract
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| PurposeThis study evaluated the effect of high-fluence accelerated corneal cross-linking on the resistance to enzymatic digestion, assessing two chromophore/light combinations: riboflavin/UV-A light (RF/UV-A) and rose bengal/green light (RB/green).MethodsFreshly prepared ex-vivo porcine corneas (n = 189) were divided into 8 groups groups. Group A corneas were unirradiated controls without chromophore soaking (A0), or soaked with riboflavin (A1) or rose bengal (A2). Group B corneas underwent accelerated epi-off RF/UV-A CXL at fluences of 5.4 J/cm(2) (B1), 10 J/cm(2) (B2), or 15 J/cm(2) (B3). Group C corneas underwent accelerated epi-off RB/green CXL at fluences of either 10 J/cm(2) (C1) or 15 J/cm(2) (C2). Following CXL, all corneas were digested in 0.3% collagenase-A solution, and the time until complete dissolution was measured.ResultsNon-irradiated controls exposed to RF and RB enhanced corneal resistance to collagenase digestion, with RB having a stronger effect than RF. RF/UV-A-treated corneas showed significantly increased digestion resistance with increasing fluence levels. RB/green-treated corneas displayed enhanced digestion resistance with each increase in fluence up to 10 J/cm(2); a 15 J/cm(2) fluence yielded similar digestion resistance times to a 10 J/cm(2) fluence, suggesting a plateau effect in accelerated RB/green CXL protocols.ConclusionsWhen compared to standard-fluence treatments, high-fluence accelerated epi-off CXL using both riboflavin and rose bengal significantly increases resistance to enzymatic digestion. The optimal settings for clinical protocols might be 15 J/cm(2) (30 mW/cm(2) for 8 min 20 s) for RF/UV-A and 10 J/cm(2) (15 mW/cm(2) for 11 min 7 s) for RB/Green Light. |
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Language
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English
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Source (journal)
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BMC ophthalmology. - London
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Publication
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London
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2024
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ISSN
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1471-2415
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DOI
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10.1186/S12886-024-03293-0
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Volume/pages
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24
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(2024)
, p. 1-7
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Article Reference
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37
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ISI
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001150524900004
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Pubmed ID
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38267904
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Full text (Publisher's DOI)
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Full text (open access)
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