Clinical Observation of Transepithelial Corneal Collagen Cross-linking by Iontophoresis of Riboflavin in Treatment of Keratoconus

Purpose: To evaluate the efficacy and safety of transepithelial collagen cross-linking by iontophoretic delivery of riboflavin in treatment of progressive keratoconus.Methods:.Eleven patients(15 eyes) with progressive keratoconus were enrolled. After 0.1% riboflavin-distilled water solution was deliveried via transepithelial iontophpresis for 5 min with 1 m A current, and ultraviolet radiation(370 nm,.3 m W /cm2) was performed at a 1.5 cm distance for 30 min. The follow up were 6 months in all eyes. The uncorrected visual acuity, corrected visual acuity,endothelial cell counting, corneal thickness,.intraocular pressure, corneal curvature, corneal topography,.OCT and corneal opacity before and 6-month after surgery were analyzed.Results: At 6 month postoperatively, mean uncorrected visual acuity and corrected visual acuity changed from 0.36 to 0.30 and from 0.42 to 0.57 without statistical significance..The mean value of each index of corneal curvature declined without statistical significance.Kmax value dereased from 60.91 to59.91, and the astigmatism declined from 3.86 to 3.19. Central corneal thickness decreased from 460.93 μm to 455.40μm,.and thinnest corneal thickness declined from 450.87 μm to 440.60 μm with no statistical significance..Intraocular pressure was significantly elevated from 10.85 mm Hg to 12.62 mm Hg. Endothelial cell count did not change significantly. No corneal haze occurred. Mean depth of corneal demarcation line was 288.46 μm at 1 month postoperatively..Conclusion:.Transepithelial corneal collagen cross-linking by iontophoresis is effective and safe in the treatment of progressive keratoconus, and yields stable clinical outcomes during 6-month follow up..However,.long-term follow up is urgently required.

Regulation of Zishen Qinggan( Shuangyi) Prescription to Insulin Resistance of GK Rats

[Objective] To study the effects of Zishen Qinggan( Shuangyi) Prescription on blood glucose,Hb A1c( glycosylated hemoglobin A1c),C-peptide( C-P),glucagon-like peptide( GLP-1),and α-glucosidase activity in GK( Goto-Kakizaki) rats. [Methods]Selected fasting blood glucose( FBG) > 11. 1mmol/L GK rats and randomly divided into groups: model group,Zishen Qinggan( Shuangyi) Prescription low dosage( ig,400 mg/kg/d),medium dosage( ig,800 mg/kg/d),and high dosage groups( ig,1600 mg/kg/d),and metformin group(ig,85 mg/kg/d). After continuous administration for 28 d,fasting blood glucose(FBG),oral glucose tolerance test(OGTT),Hb A1 c,C-P,GLP-1 and α-glucosidase activity were detected. [Results] Compared with the control group,FBG and Hb A1 c of the model group was significantly higher( P < 0. 01); compared with the model group,Zishen Qinggan( Shuangyi) Prescription could significantly reduce the levels of blood glucose,Hb A1 c,and the elevated blood glucose levels after 120 min of glucose loading in OGTT( P < 0. 05,P < 0. 01),and also can significantly improve the level of C-P,GLP-1( P < 0. 05,P < 0. 01),reduce Homa-IR,and inhibit α-glucosidase activity. [Conclusions]Zishen Qinggan( Shuangyi) Prescription can effectively reduce the blood glucose of GK rats,the action mechanism of which is possibly that it can improve insulin resistance,increase GLP-1 content and inhibit α-glucosidase activity.