A recent publication in Translational Vision Science & Technology, titled “Combining Riboflavin/UV-A Light and Rose Bengal/Green Light Corneal Cross-Linking Increases the Resistance of Corneal Enzymatic Digestion” by the ELZA Institute’s M. Enes Aydemir and colleagues, presents an insightful study into corneal cross-linking (CXL), and how performing sequential corneal cross-linking with riboflavin/UV and rose bengal/green light protocols can increase corneal enzymatic digestion resistance greater than each protocol on its own.
The focus of the study was to assess whether a concurrent application of riboflavin/UV-A light (RF/UV-A) and rose Bengal/green light (RB/green) in epi-off PACK-CXL could enhance corneal resistance to enzymatic digestion, compared to separate chromophore/light treatments. Conducted in ex vivo porcine corneas, the experiment was methodically structured into three groups, each subjected to varying degrees of RF and RB treatments, with and without light exposure. The outcomes indicated that the corneas treated with the combined RF/UV-A and RB/green methodology exhibited a notable increase in resistance to enzymatic digestion than those treated separately.
This study’s findings are particularly relevant in the context of infectious keratitis (IK), a significant cause of blindness globally. The enhanced resistance to enzymatic digestion noted in the combined treatment approach suggests potential for improved treatment efficacy in IK, especially in cases where traditional therapies are less effective. The study posits that this increase in corneal durability could lead to smaller ulcer sizes in clinical scenarios, which is crucial for patient recovery.
Additionally, the research underscores the potential translational impact of this combined CXL approach. The study suggests that this method could notably strengthen corneal resistance against collagenase digestion, a key factor in the progression of IK. This insight into the synergistic effect of RF/UV-A and RB/green light in CXL provides a valuable perspective for future therapeutic strategies in corneal diseases, especially in the face of rising antimicrobial resistance.
In summary, Aydemir et al.’s research offers a significant contribution to the field of ophthalmology, particularly in the area of corneal disease treatment. The combined RF/UV-A and RB/green light approach in PACK-CXL presents a promising direction for future research and clinical application, potentially enhancing the management and outcomes of infectious keratitis.
