PURPOSE To assess corneal concentration of riboflavin in two different corneal crosslinking protocols performed by a novel image-guided therapeutic (or "theranostic") UV-A device. METHODS Ten human eye bank donor tissues were used in this work. The tissues underwent corneal cross-linking according to the conventional treatment protocol (n = 5; 30 min of stromal soaking followed by 30 min of 3 mW/cm2 UV-A irradiance) and the iontophoresis-assisted transepithelial protocol (n = 5; soaking for 5 min at 1 mA/min and 9 min of 10 mW/cm2 UV-A irradiance) using a theranostic UV-A device (Vision Engineering Italy srl, Italy). The device provided real time assessment of riboflavin concentration by hyperspectral image analysis of the cornea. A 0.1% riboflavin hypotonic solution (Ricrolin+, Sooft Italia Spa, Italy) was used in all cases. RESULTS Manual application of hypotonic riboflavin for 30 min into the stroma achieved greater corneal riboflavin concentration (425 ± 77 μg/cm3) than transepithelial delivery of riboflavin by corneal iontophoresis (195 ± 35 μg/cm3; P = 0.001). In both UV-A irradiation protocols, corneal riboflavin concentration decreased exponentially with a constant energy rate of 2.3 ± 0.5 J/cm2 and 1.8 ± 0.3 J/cm2 respectively. At the end of treatment, the average corneal concentration of riboflavin decreased by ≥ 85%, with values of 54 ± 29 μg/cm3 and 31 ± 9 μg/cm3 (P = 0.11), respectively. CONCLUSION Manual application of riboflavin onto the stroma achieved almost 50% greater concentration of riboflavin than transepithelial delivery by corneal iontophoresis. The theranostic UV-A device provided a novel approach to estimate corneal concentration of riboflavin non-invasively during treatment.

中文翻译：

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使用血管扩张型UV-A装置比较标准角膜和经上皮角膜的交联。

目的评估由新颖的图像引导治疗（或“ theranostic”）UV-A设备执行的两种不同的角膜交联方案中核黄素的角膜浓度。方法十个人眼银行供体组织用于这项工作。根据常规治疗方案对组织进行角膜交联（n = 5；基质浸泡30分钟，然后用3 mW / cm2的UV-A辐照30分钟）和离子电渗疗法辅助的经上皮协议（n = 5；浸泡）使用医疗用UV-A装置（Vision Engineering Italy srl，Italy）在1 mA / min和9 min的10 mW / cm2 UV-A辐照下放置5分钟。该设备通过角膜的高光谱图像分析提供了核黄素浓度的实时评估。在所有情况下均使用0.1％的核黄素低渗溶液（Ricrolin +，意大利Sooft Italia Spa）。结果相比于通过角膜电渗透皮上皮递送核黄素（195±35μg/ cm3，P = 0.001），将低渗核黄素手动施用至基质中30分钟可达到更高的角膜核黄素浓度（425±77μg/ cm3）。在这两种UV-A辐照方案中，角膜核黄素浓度分别以2.3±0.5 J / cm2和1.8±0.3 J / cm2的恒定能量速率呈指数下降。在治疗结束时，核黄素的平均角膜浓度降低了≥85％，分别为54±29μg/ cm3和31±9μg/ cm3（P = 0.11）。结论手工将核黄素施加到基质上比通过角膜离子电渗入经上皮传递的核黄素浓度高近50％。