Experimental study of riboflavin-ultraviolet A collagen crosslinking for the treatment of alkali-induced corneal burns in rabbits

中华眼外伤职业眼病杂志 Pub Date : 2019-09-25 DOI:10.3760/CMA.J.ISSN.2095-1477.2019.09.005

Chunxiu Ming, Limei Liu, Shaobin Zhang, Ya-li Zhang, Sheng Wang

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Abstract

Objective To evaluate the efficacy of riboflavin-ultraviolet A (UVA) collagen crosslinking (CXL) combined with drugs for the treatment of alkali-induced corneal burns in rabbits. Methods Prospective experimental study.The corneas of left eyes of 40 healthy New Zealand rabbits were established alkali burn model. All rabbits were randomly divided into 4 groups: the model group, drugs treatment group, crosslinking group and combined group, with 10 cases in each group. The model goup received no treatments. The drug goup received drug treatment. Riboflavin-UVA collagen crosslinking was appied in crosslinking group and the combined group received CXL combined with drug treatment. Therapeutic efficacy of each group were compared at 1 and 3 months after operation. Results The corneal epithelial healing time in the model group, drug group, cross-linking group and combined group were (32.9±5.8 ), (12.8±2.3), (25.9±3.2 ) and (10.7±2.5 )days, respectively. The difference were statistically significant among the four groups (F=67.647, P=0.000) . The corneal turbidity score of combined group was the lowest among the 4 groups, followed by the drug group, and the score of model group was the heaviest (F=6.446, P=0.001). The number of inflammatory cells were (162.6±33.3), (46.0±21.3 ), (87.9±7.5)and (8.3±6.5)cells respectively under single confocal microscopy field of vision ( 400 μm×400 μm). The difference among the 4 groups was statistically significant (χ2=36.040, P=0.000). The corneal collagen fibers with pathological examination in the combined group were the thickest and densely arranged, followed by crosslinking group. Conclusion The efficacy of drug combined with cross-linking for the treatment of corneal alkali burn in rabbits is better than that of simple drug therapy or simple corneal collagen cross-linking. Key words: Riboflavin-ultraviolet A; Collagen; Crosslinking; Burn, alkali, coreal

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核黄素-紫外线A胶原交联治疗兔碱性角膜烧伤的实验研究

目的评价核黄素-紫外线A (UVA)胶原交联(CXL)联合药物治疗家兔碱性角膜烧伤的疗效。方法前瞻性实验研究。以40只健康新西兰兔左眼角膜为材料，建立碱烧伤模型。将所有家兔随机分为4组:模型组、药物治疗组、交联组和联合组，每组10只。模型组不给予任何治疗。药物组接受药物治疗。交联组采用核黄素- uva胶原交联，联合组采用CXL联合药物治疗。比较两组患者术后1、3个月的疗效。结果模型组、药物组、交联组、联合组角膜上皮愈合时间分别为(32.9±5.8)、(12.8±2.3)、(25.9±3.2)、(10.7±2.5)d。四组间差异有统计学意义(F=67.647, P=0.000)。联合用药组角膜混浊评分最低，药物组次之，模型组评分最高(F=6.446, P=0.001)。在400 μm×400 μm单共聚焦显微镜视野下，炎症细胞数分别为(162.6±33.3)个、(46.0±21.3)个、(87.9±7.5)个和(8.3±6.5)个。4组间差异有统计学意义(χ2=36.040, P=0.000)。病理检查，联合组角膜胶原纤维最厚、排列最密，其次为交联组。结论药物联合交联治疗兔角膜碱烧伤的疗效优于单纯药物治疗或单纯角膜胶原交联治疗。关键词:核黄素-紫外线A;胶原蛋白;交联;燃烧，碱，核

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