Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement o...Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.展开更多
AIM: To evaluate the effect of Collagen cross-linking on the prevention of melting in rabbit corneas after alkali burn. METHODS: Twenty New Zealand white rabbits were randomly divided into model control group and coll...AIM: To evaluate the effect of Collagen cross-linking on the prevention of melting in rabbit corneas after alkali burn. METHODS: Twenty New Zealand white rabbits were randomly divided into model control group and collagen cross-linking treatment group. The second group of rabbits received collagen cross linked treatment. Both groups were applied with antibiotic eye drops to prevent infection. The corneas were evaluated for melting, opacity, pathological and immunohistochemistry, record the changes when 28 days after the animals were killed. RESULTS: In the control group, 6 out of 8 rabbits showed corneal melting after injury (14 +/- 4) days, while two corneal perforated. In collagen cross-linking treatment group, one rabbit showed corneal melting after injury 23 days, without corneal perforation; corneal dissolution rate between the two groups was significantly different (P <0.05). Pathological examination suggested that in the treatment group, mild corneal edema, mild damage to collagen fibers, inflammatory cell infiltration was significantly less than the control group. Immunohistochemistry showed that corneal collagen fibers arranged in neat rows in the control group. CONCLUSION: Collagen cross-linking treatment not only can prevent and delay the corneal melting after alkali burn, but also can reduce the destruction of corneal collagen fibers and infiltration of inflammatory cells in the corneal tissue.展开更多
AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age ...AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure.RESULTS: The mean thinnest thickness of the cornea was 408.5 ±29.0 μm before treatment and reduced to369.8 ±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0 ±26.5 μm before CXL and recover to 412.5 ±22.7 μm at 3mo after treatment, P =0.659). Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6 ±4.0 diopters, and slightly decreased(54.7±4.9 diopters) after surgery(P =0.085). Mean best-corrected visual acuity was 0.55 ±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery(P =0.879).The endothelial cell density was 2706.4 ±201.6 cells/mm2 before treatment, and slightly decreased( 2641. 2 ±218.2 cells/mm2) at last fellow up(P =0.002).CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.展开更多
AIM: To observe the therapeutic effect of corneal collagen cross-linking(CXL) in combination with liposomal amphotericin B in fungal corneal ulcers.METHODS: New Zealand rabbits were induced fungal corneal ulcers b...AIM: To observe the therapeutic effect of corneal collagen cross-linking(CXL) in combination with liposomal amphotericin B in fungal corneal ulcers.METHODS: New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B(n =5 each). The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28 d after treatment. The corneas were examined with transmission electron microscopy(TEM) at 4wk.RESULTS: A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d(P 〈0.05). The corneal epithelium defect areas of the combined group was smaller than that of the CXL group(P 〈0.05) on 7 and 14 d, but there were no statistical differences on 3, 21 and 28 d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28 d. The diameters of the corneal collagen fiber bundles(42.960 ±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group) were thicker than that of the control group(24.900±1.868 nm),but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION: CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.展开更多
AIM:To compare the anterior and posterior corneal parameters before and after collagen cross-linking therapy for keratoconus.METHODS:Collagen cross-linking was performed in31 eyes of 31 keratoconus patients(mean age 3...AIM:To compare the anterior and posterior corneal parameters before and after collagen cross-linking therapy for keratoconus.METHODS:Collagen cross-linking was performed in31 eyes of 31 keratoconus patients(mean age 30.6±8.9y).Prior to treatment and an average 7mo after therapy,Scheimpflug analysis was performed using Pentacam HR.In addition to corneal thickness assessments,corneal radius,elevation,and aberrometric measurements were performed both on anterior and posterior corneal surfaces.Data obtained before and after surgery were statistically analyzed.RESULTS:In terms of horizontal and vertical corneal radius,and central corneal thickness no deviations were observed an average 7mo after operation.Corneal higher order aberration showed no difference neither on anterior nor on posterior corneal surfaces.During follow-up period,no significant deviation was detected regarding elevation values obtained by measurement in mm units between the 3.0-8.0 mm-zones.CONCLUSION:Corneal stabilization could be observed in terms of anterior and posterior corneal surfaces,elevation and higher order aberration values 7mo after collagen cross-linking therapy for keratoconus.展开更多
AIM:To evaluate the effect of posterior sclera collagen cross-linking induced by riboflavin-ultraviolet A(UVA)on form-deprived myopia in guinea pigs.METHODES:Twenty-five pigmented guinea pigs of 3-week-old were random...AIM:To evaluate the effect of posterior sclera collagen cross-linking induced by riboflavin-ultraviolet A(UVA)on form-deprived myopia in guinea pigs.METHODES:Twenty-five pigmented guinea pigs of 3-week-old were randomly assigned into 4 groups that included normal control(NOR,n=7),form-deprived(FDM,n=7),normal with riboflavin-UVA cross-linking(NOR+CL,n=5)and form-deprived with cross-linking(FDM+CL,n=6).The NOR+CL group and the FDM+CL group received the riboflavin-UVA induced cross-linking at day 0.FDM was induced by monocularly deprived with facemask in the right eyes.The refraction,axial length and corneal curvature were measured by retinoscopy,A-scan and keratometer respectively in scheduled time points(day 0 and 1,2,3,4 wk after form-deprivation).At the end of 4 weeks’experiment,stress-strain tests of sclera were measured and morphological changes of sclera and retina were examined.RESULTS:After 4 wk,the interocular difference of refractive error were-0.11±0.67,-2.93±0.56,1.10±0.58,and-1.63±0.41 D in the NOR,FDM,NOR+CL,and FDM+CL groups respectively.Mixed-effect linear model revealed significant effect of FDM(P<0.01)and CL(P<0.001).Also,after 4 wk,the interocular difference of axial length were 0.01±0.04,0.29±0.07,-0.13±0.06,and 0.11±0.05 mm in the NOR,FDM,NOR+CL,and FDM+CL group.Mixedeffect linear model revealed significant effect of FDM(P<0.001)and CL(P<0.01).As for corneal curvature,significant interocular difference have not found between any of the two groups.At the end of this experiment,the ultimate stress and elastic modulus were found significantly increased in both CL groups.But no difference was found in the groups without cross-linked.There was no abnormality observed in the retina and RPE cells of the treated eyes.CONCLUSION:The posterior sclera collagen crosslinking induced by riboflavin-UVA can slow down the progress of myopia and increase the sclera biomechanical strength in the guinea pig model of form-deprived myopia.展开更多
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...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.展开更多
As a photochemical reaction that can stiffen the cornea,corneal collagen cross-linking(CXL) is the only promising method of preventing the progress of keratectasia,such as keratoconus and secondary ectasia following r...As a photochemical reaction that can stiffen the cornea,corneal collagen cross-linking(CXL) is the only promising method of preventing the progress of keratectasia,such as keratoconus and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition,with a small chance of visual improvement. Combining CXL with refractive surgery targeting both stabilization and reshaping of the corneal tissue for visual function improvement is a good treatment option. This review aims to provide a comprehensive and unbiased summary of the published research regarding combined CXL and refractive surgery,including measures and results,to help elucidate the future direction of CXL.展开更多
In this review,recent studies regarding riboflavin-ultraviolet A(UVA)collagen cross-linking for the treatment of acanthamoeba keratitis(AK)were reviewed.English written studies about acanthamoeba,keratitis,riboflavin ...In this review,recent studies regarding riboflavin-ultraviolet A(UVA)collagen cross-linking for the treatment of acanthamoeba keratitis(AK)were reviewed.English written studies about acanthamoeba,keratitis,riboflavin and collagen cross-linking were retrieved from PubMed search engine(www.ncbi.nlm.nih.gov/pubmed).Although there were significant numbers of cases reporting the effectiveness of riboflavin-UVA collagen cross-linking in AK,experimental studies(in vivo and in vitro)failed to verify amoebicidal or cysticidal effect of riboflavin-UVA collagen cross-linking.In conclusion,the efficacy of riboflavin-UVA collagen cross-linking for the treatment of AK is still debatable.It is necessary to conduct a prospective case-control study for clear guidance for clinicians.展开更多
Purpose:To assess the effect of having an open or closed eye on the variation in central corneal thickness during riboflavin instillation for corneal collagen cross-linking (CXL).Methods:.Thirty eyes of 15 New Zealand...Purpose:To assess the effect of having an open or closed eye on the variation in central corneal thickness during riboflavin instillation for corneal collagen cross-linking (CXL).Methods:.Thirty eyes of 15 New Zealand White rabbits underwent an in vivo anterior segment optical coherence tomography (OCT) examination at 0,10,20,and 30 min after riboflavin instillation on the de-epithelialized corneal surface.Each eye of every rabbit was randomly placed into one of two different treatment groups(open-eye or closed-eye)during the instillation;.the examinations were performed one after the other.After instillation for 30 min,the changes in the corneal stroma and anterior chamber were observed by slit lamp.Results:.A significant decrease in the central corneal thickness(CCT).was demonstrated during riboflavin instillation;.the variations were smaller in the measurements performed with the eye closed than with the eye open.(81.36±15.13μm and129.20±12.05μm respectively)..Both methods turned the corneal stroma and anterior chamber yellow.Conclusion:Keeping the eye closed during riboflavin instillation reduced the decrease in the CCT..The same yellow change in the corneal stroma and anterior chamber occurred,but the exposure time of the ocular surface was shorter.Therefore,.keeping the eye closed was a more effective and safer method than keeping the eye open.展开更多
Purpose:To study variation in central corneal thickness (CCT) during corneal collagen cross-linking(CXL) using ultrasound pachymetry. Methods:Twenty patients (26 eyes) with progressing keratoconus undergoing riboflavi...Purpose:To study variation in central corneal thickness (CCT) during corneal collagen cross-linking(CXL) using ultrasound pachymetry. Methods:Twenty patients (26 eyes) with progressing keratoconus undergoing riboflavin-UVA-induced CXL were involved in this study. Intraoperative CCT measurement using ultrasonic pachymetry was performed during the procedure.Measurements were obtained before operation, after epithelial removal, after riboflavin drop instillation, and after UVA irradiation. Results:Mean CCT was 495±56 and 450±52 μm before and after epithelial removal, respectively. Mean CCT was 443±42 and 411±39 μm after riboflavin drop instillation and after UVA irradiation, respectively. Statistically significant decreases in CCT occurred between the preoperative period and after epithelial removal, after riboflavin drop instillation and after UVA irradiation. Twenty-six eyes from 20 patients undergoing CXL were divided into 2 groups (I with CCT≥400 μm after UVA irradiation and II with CCT<400 μm after UVA irradiation). No statistically significant difference was noted between I and II in preoperative endothelial cell count, but a statistically greater postoperative endothelial cell count was noted in I compared to II. A statistically significant difference was evident between preoperative and postoperative endothelial cell counts in Group II (P<0.05). Conclusion:Performing CXL with the use of riboflavin and UVA irradiation resulted in a statistically significant decrease in CCT, to a level where the corneal endothelium may be damaged.(Eye Science 2013; 28:15-19)展开更多
Background and aim:Keratoconus is a slowly progressive and non-inflammatory disease of eye of unknown etiology characterized by significant structural degeneration,thinning and protrusion of cornea.Collagen cross link...Background and aim:Keratoconus is a slowly progressive and non-inflammatory disease of eye of unknown etiology characterized by significant structural degeneration,thinning and protrusion of cornea.Collagen cross linking using Riboflavin/ultraviolet A,paraformaldehyde and glutaraldehyde has been widely used to treat keratoconus,but these techniques have several clinical complications.This study aimed to develop a rapid,safer,less toxic and more effective method to increase the corneal stiffness hence treating keratoconus by using EDC/NHS coupling with pimelic acid(PA)as cross-linkers.Methods:The viability of corneal epithelial and endothelial cells was examined using Alamar blue.The corneal collagen and tissue integrity were evaluated with Masson and hematoxylin and eosin stains respectively.Uniaxial tensile testing was conducted to determine the tissue stiffness.We further assessed the effective penetration depth of cross-linking by fluorescence dye and confocal microscopy.TUNEL assay was performed to detect the damaged DNA fragments in the presence of PA.Results:The effect of PA solution on corneal cross-linking showed a significant increase in corneal rigidity without affecting the epithelium integrity under neutralized pH condition,while DEC/NHS alone did not induce the mechanical property.The penetration depth showed consistent results with increased stiffness,which could be affected by the parameters including pH condition,coupling with or without PA.In addition,PA significantly decreased the percentage of TUNEL-positive cells compared to that of EDC/NHS only condition.The cytotoxic effect to endothelium was considered minimal and protected in the presence of PA.Conclusions:We demonstrated PA as a potential alternative for cross-linking in the model of whole eye with intact epithelium and its protective role on endothelium.The administration of this chemical cross-linker stands as an extremely promising technique for the treatment of corneal keratoconus.展开更多
Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for random...Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.展开更多
AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHO...AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.展开更多
Since the late 1990s corneal crosslinking(CXL)has been proposed as a new possibility to stop progression of keratoconus or secondary corneal ectasia,with the promising aim to prevent progressive visual loss due to the...Since the late 1990s corneal crosslinking(CXL)has been proposed as a new possibility to stop progression of keratoconus or secondary corneal ectasia,with the promising aim to prevent progressive visual loss due to the evolution of the pathology and to delay or avoid invasive surgical procedures such as corneal transplantation.The possibility of strengthening corneal tissue by means of a photochemical reaction of corneal collagen by the combined action of Riboflavin and ultraviolet A irradiation(UVA),radically modified the conservative management of progressive corneal ectasia.This is a review of the state of the art of CXL,reporting basic and clinical evidence.The paper describes basic principles,advantages and limits of different CXL techniques and possible future evolution of the procedure.展开更多
Corneal collagen cross-linking(CXL)is a therapeutic procedure aiming at increasing the corneal stiffness in the keratoconus eyes by induction of cross-links within the extracellular matrix.It is achieved by ultraviole...Corneal collagen cross-linking(CXL)is a therapeutic procedure aiming at increasing the corneal stiffness in the keratoconus eyes by induction of cross-links within the extracellular matrix.It is achieved by ultraviolet-A(370 nm)irradiation of the cornea after saturation with the photosensitizer riboflavin.In the conventional CXL protocol,a minimum de-epithelialized corneal thickness of 400μm is recommended to avoid potential irradiation damage to the corneal endothelium.In advanced keratoconus,however,stromal thickness is often lower than 400μm,which limits the application of CXL in that category.Efforts have been undertaken to modify the conventional CXL procedure to be applicable in thin corneas.The current review discusses different techniques employed to achieve this end and their results.The overall safety and efficacy of the modified CXL protocols are good,as most of them managed to halt the progression of keratectasia without postoperative complications.However,the evidence of safety and efficacy in the use of modified CXL protocols is still limited to few studies with few patients involved.Controlled studies with long-term follow-up are required to confirm the safety and efficacy of the modified protocols.展开更多
Polyimide(PI)is a promising electronic packaging material,but it remains challenging to obtain an all-organic PI hybrid film with decreased dielectric constant and loss without modifying the monomer.Herein,a series of...Polyimide(PI)is a promising electronic packaging material,but it remains challenging to obtain an all-organic PI hybrid film with decreased dielectric constant and loss without modifying the monomer.Herein,a series of allorganic PI hybrid films were successfully prepared by introducing the covalent organic framework(COF),which could induce the formation of the cross-linking structure in the PI matrix.Due to the synergistic effects of the COF fillers and the cross-linking structure,the PI/COF hybrid film containing 2 wt%COF exhibited the lowest dielectric constant of 2.72 and the lowest dielectric loss(tanδ)of 0.0077 at 1 MHz.It is attributed to the intrinsic low dielectric constant of COF and a large number of mesopores within the PI.Besides,the cross-linking network of PI prevents the molecular chains from stacking and improves the fraction of free volume(FFV).The molecular dynamics simulation results are well consistent with the dielectric properties data.Furthermore,the PI/COF hybrid film with 5 wt%COF showed a significant enhancement in breakdown strength,which increased to 412.8 kV/mm as compared with pure PI.In addition,the PI/COF hybrid film achieve to reduce the dielectric constant and thermal expansion coefficient(CTE).It also exhibited excellent thermal,hydrophobicity,and mechanical performance.The all-organic PI/COF hybrid films have great commercial potential as next-generation electronic packaging materials.展开更多
Objective The aim of this review is to comprehensively and unbiasedly summarize the improvements in the techniques for classical corneal collagen cross-linking (CXL) by covering the reasons for this improvement, mea...Objective The aim of this review is to comprehensively and unbiasedly summarize the improvements in the techniques for classical corneal collagen cross-linking (CXL) by covering the reasons for this improvement, measure, and effect to approach the future direction of the CXL. Data sources All articles used in this review were mainly retrieved from the PubMed database. Study selection Original articles and reviews were selected if they were related to the improvement in the technique of classical CXL. Data were mainly extracted from 94 articles, which are listed in the reference section of this review. Results This innovative research involves every step such as instrument preparation, epithelial management, riboflavin instillation, and UVA irradiation. These clinical and experimental results seem promising. Conclusions CXL treatment is the only recent promising method for preventing the progress of keratoconus. The limitations and potential complications that accompany classical CXL such as corneal thickness limitations, ultraviolet-A (UVA) light injury, and the impact of de-epithelialization encourage people to research new improvements in techniques. While this research needs to be further investigated, we hope our review can help related researchers and patients.展开更多
This research paper describes the synthesis of thermo-reversible cross-linking of sago starch by grafting a furan pendant group(methyl 2-furoate)onto the starch backbone,followed by a Diels-Alder(DA)reaction of the fu...This research paper describes the synthesis of thermo-reversible cross-linking of sago starch by grafting a furan pendant group(methyl 2-furoate)onto the starch backbone,followed by a Diels-Alder(DA)reaction of the furan functional group with 1,1′-(methylenedi-4,1-phenylene)bismaleimide(BM).The proof of principles was provided by FTIR and 1H-NMR analyses.The relevant FTIR peaks are the carbonyl peak(υC=O sym)at 1721 cm^(−1);the two peaks appeared after DA cross-linking,i.e.,at 1510 cm^(−1)(corresponding toυCH=CH BM aromatic rings,stretching vibrations),and at 1173 cm^(−1)(assigned to cycloadduct(C-O-C,δDA ring))while the^(1)H-NMR result shows evidence for the presence of a furan ring in the starch matrices(in the range ofδ6.3-7.5 ppm).The crosslinked starch product is indeed thermally reversible,as is evident from the appearance of exothermal(DA,temperature range of 50℃-70℃)and endothermal(retro DA,temperature range of 125℃-150℃)transitions in the DSC thermograms.This paper not only proves the thermal reversibility but also demonstrates that the final product properties(chemical,morphology,and thermal stability)can be tuned by varying the annealing temperature,BM intake,and reaction time.展开更多
This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instan...This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instant ejection steam explosion(ICSE)combined with enzymatic hydrolysis,followed by chelation reaction to prepare rabbit bone peptide-calcium chelate(RBCP-Ca).The chelating sites were further analyzed by liquid chromatography-tandem mass(LC-MS/MS)spectrometry while the chelating mechanism and binding modes were investigated.The structural characterization revealed that RBCP successfully chelated with calcium ions.Furthermore,LC-MS/MS analysis indicated that the binding sites included both acidic amino acids(Asp and Glu)and basic amino acids(Lys and Arg),Interestingly,three binding modes,namely Inter-Linking,Loop-Linking and Mono-Linking were for the first time found,while Inter-Linking mode accounted for the highest proportion(75.1%),suggesting that chelation of calcium ions frequently occurred between two peptides.Overall,this study provides a theoretical basis for the elucidation of chelation mechanism of calcium-chelating peptides.展开更多
文摘Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.
文摘AIM: To evaluate the effect of Collagen cross-linking on the prevention of melting in rabbit corneas after alkali burn. METHODS: Twenty New Zealand white rabbits were randomly divided into model control group and collagen cross-linking treatment group. The second group of rabbits received collagen cross linked treatment. Both groups were applied with antibiotic eye drops to prevent infection. The corneas were evaluated for melting, opacity, pathological and immunohistochemistry, record the changes when 28 days after the animals were killed. RESULTS: In the control group, 6 out of 8 rabbits showed corneal melting after injury (14 +/- 4) days, while two corneal perforated. In collagen cross-linking treatment group, one rabbit showed corneal melting after injury 23 days, without corneal perforation; corneal dissolution rate between the two groups was significantly different (P <0.05). Pathological examination suggested that in the treatment group, mild corneal edema, mild damage to collagen fibers, inflammatory cell infiltration was significantly less than the control group. Immunohistochemistry showed that corneal collagen fibers arranged in neat rows in the control group. CONCLUSION: Collagen cross-linking treatment not only can prevent and delay the corneal melting after alkali burn, but also can reduce the destruction of corneal collagen fibers and infiltration of inflammatory cells in the corneal tissue.
文摘AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure.RESULTS: The mean thinnest thickness of the cornea was 408.5 ±29.0 μm before treatment and reduced to369.8 ±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0 ±26.5 μm before CXL and recover to 412.5 ±22.7 μm at 3mo after treatment, P =0.659). Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6 ±4.0 diopters, and slightly decreased(54.7±4.9 diopters) after surgery(P =0.085). Mean best-corrected visual acuity was 0.55 ±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery(P =0.879).The endothelial cell density was 2706.4 ±201.6 cells/mm2 before treatment, and slightly decreased( 2641. 2 ±218.2 cells/mm2) at last fellow up(P =0.002).CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.
基金Supported by Nature Science Fundamental Research Planned Projects of Shaanxi Province(No.2011JE005No.2012JM4023)Science and Technology Planned Projects of Xi'an[No.SF1207(1)]
文摘AIM: To observe the therapeutic effect of corneal collagen cross-linking(CXL) in combination with liposomal amphotericin B in fungal corneal ulcers.METHODS: New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B(n =5 each). The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28 d after treatment. The corneas were examined with transmission electron microscopy(TEM) at 4wk.RESULTS: A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d(P 〈0.05). The corneal epithelium defect areas of the combined group was smaller than that of the CXL group(P 〈0.05) on 7 and 14 d, but there were no statistical differences on 3, 21 and 28 d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28 d. The diameters of the corneal collagen fiber bundles(42.960 ±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group) were thicker than that of the control group(24.900±1.868 nm),but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION: CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.
文摘AIM:To compare the anterior and posterior corneal parameters before and after collagen cross-linking therapy for keratoconus.METHODS:Collagen cross-linking was performed in31 eyes of 31 keratoconus patients(mean age 30.6±8.9y).Prior to treatment and an average 7mo after therapy,Scheimpflug analysis was performed using Pentacam HR.In addition to corneal thickness assessments,corneal radius,elevation,and aberrometric measurements were performed both on anterior and posterior corneal surfaces.Data obtained before and after surgery were statistically analyzed.RESULTS:In terms of horizontal and vertical corneal radius,and central corneal thickness no deviations were observed an average 7mo after operation.Corneal higher order aberration showed no difference neither on anterior nor on posterior corneal surfaces.During follow-up period,no significant deviation was detected regarding elevation values obtained by measurement in mm units between the 3.0-8.0 mm-zones.CONCLUSION:Corneal stabilization could be observed in terms of anterior and posterior corneal surfaces,elevation and higher order aberration values 7mo after collagen cross-linking therapy for keratoconus.
基金Supported by the Tianjin Clinical Key Discipline Project(No.TJLCZDXKQ013)the Research Project of Health Committee in Binhai District,Tianjin(No.2019BWKQ033)。
文摘AIM:To evaluate the effect of posterior sclera collagen cross-linking induced by riboflavin-ultraviolet A(UVA)on form-deprived myopia in guinea pigs.METHODES:Twenty-five pigmented guinea pigs of 3-week-old were randomly assigned into 4 groups that included normal control(NOR,n=7),form-deprived(FDM,n=7),normal with riboflavin-UVA cross-linking(NOR+CL,n=5)and form-deprived with cross-linking(FDM+CL,n=6).The NOR+CL group and the FDM+CL group received the riboflavin-UVA induced cross-linking at day 0.FDM was induced by monocularly deprived with facemask in the right eyes.The refraction,axial length and corneal curvature were measured by retinoscopy,A-scan and keratometer respectively in scheduled time points(day 0 and 1,2,3,4 wk after form-deprivation).At the end of 4 weeks’experiment,stress-strain tests of sclera were measured and morphological changes of sclera and retina were examined.RESULTS:After 4 wk,the interocular difference of refractive error were-0.11±0.67,-2.93±0.56,1.10±0.58,and-1.63±0.41 D in the NOR,FDM,NOR+CL,and FDM+CL groups respectively.Mixed-effect linear model revealed significant effect of FDM(P<0.01)and CL(P<0.001).Also,after 4 wk,the interocular difference of axial length were 0.01±0.04,0.29±0.07,-0.13±0.06,and 0.11±0.05 mm in the NOR,FDM,NOR+CL,and FDM+CL group.Mixedeffect linear model revealed significant effect of FDM(P<0.001)and CL(P<0.01).As for corneal curvature,significant interocular difference have not found between any of the two groups.At the end of this experiment,the ultimate stress and elastic modulus were found significantly increased in both CL groups.But no difference was found in the groups without cross-linked.There was no abnormality observed in the retina and RPE cells of the treated eyes.CONCLUSION:The posterior sclera collagen crosslinking induced by riboflavin-UVA can slow down the progress of myopia and increase the sclera biomechanical strength in the guinea pig model of form-deprived myopia.
文摘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.
文摘As a photochemical reaction that can stiffen the cornea,corneal collagen cross-linking(CXL) is the only promising method of preventing the progress of keratectasia,such as keratoconus and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition,with a small chance of visual improvement. Combining CXL with refractive surgery targeting both stabilization and reshaping of the corneal tissue for visual function improvement is a good treatment option. This review aims to provide a comprehensive and unbiased summary of the published research regarding combined CXL and refractive surgery,including measures and results,to help elucidate the future direction of CXL.
基金The study is supported in part by a grant of Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education(2016R1D1A1B03931724).
文摘In this review,recent studies regarding riboflavin-ultraviolet A(UVA)collagen cross-linking for the treatment of acanthamoeba keratitis(AK)were reviewed.English written studies about acanthamoeba,keratitis,riboflavin and collagen cross-linking were retrieved from PubMed search engine(www.ncbi.nlm.nih.gov/pubmed).Although there were significant numbers of cases reporting the effectiveness of riboflavin-UVA collagen cross-linking in AK,experimental studies(in vivo and in vitro)failed to verify amoebicidal or cysticidal effect of riboflavin-UVA collagen cross-linking.In conclusion,the efficacy of riboflavin-UVA collagen cross-linking for the treatment of AK is still debatable.It is necessary to conduct a prospective case-control study for clear guidance for clinicians.
文摘Purpose:To assess the effect of having an open or closed eye on the variation in central corneal thickness during riboflavin instillation for corneal collagen cross-linking (CXL).Methods:.Thirty eyes of 15 New Zealand White rabbits underwent an in vivo anterior segment optical coherence tomography (OCT) examination at 0,10,20,and 30 min after riboflavin instillation on the de-epithelialized corneal surface.Each eye of every rabbit was randomly placed into one of two different treatment groups(open-eye or closed-eye)during the instillation;.the examinations were performed one after the other.After instillation for 30 min,the changes in the corneal stroma and anterior chamber were observed by slit lamp.Results:.A significant decrease in the central corneal thickness(CCT).was demonstrated during riboflavin instillation;.the variations were smaller in the measurements performed with the eye closed than with the eye open.(81.36±15.13μm and129.20±12.05μm respectively)..Both methods turned the corneal stroma and anterior chamber yellow.Conclusion:Keeping the eye closed during riboflavin instillation reduced the decrease in the CCT..The same yellow change in the corneal stroma and anterior chamber occurred,but the exposure time of the ocular surface was shorter.Therefore,.keeping the eye closed was a more effective and safer method than keeping the eye open.
文摘Purpose:To study variation in central corneal thickness (CCT) during corneal collagen cross-linking(CXL) using ultrasound pachymetry. Methods:Twenty patients (26 eyes) with progressing keratoconus undergoing riboflavin-UVA-induced CXL were involved in this study. Intraoperative CCT measurement using ultrasonic pachymetry was performed during the procedure.Measurements were obtained before operation, after epithelial removal, after riboflavin drop instillation, and after UVA irradiation. Results:Mean CCT was 495±56 and 450±52 μm before and after epithelial removal, respectively. Mean CCT was 443±42 and 411±39 μm after riboflavin drop instillation and after UVA irradiation, respectively. Statistically significant decreases in CCT occurred between the preoperative period and after epithelial removal, after riboflavin drop instillation and after UVA irradiation. Twenty-six eyes from 20 patients undergoing CXL were divided into 2 groups (I with CCT≥400 μm after UVA irradiation and II with CCT<400 μm after UVA irradiation). No statistically significant difference was noted between I and II in preoperative endothelial cell count, but a statistically greater postoperative endothelial cell count was noted in I compared to II. A statistically significant difference was evident between preoperative and postoperative endothelial cell counts in Group II (P<0.05). Conclusion:Performing CXL with the use of riboflavin and UVA irradiation resulted in a statistically significant decrease in CCT, to a level where the corneal endothelium may be damaged.(Eye Science 2013; 28:15-19)
基金Project supported by the Natural Science Foundation of Guangdong Province,China(Grant No.2019A1515110158)。
文摘Background and aim:Keratoconus is a slowly progressive and non-inflammatory disease of eye of unknown etiology characterized by significant structural degeneration,thinning and protrusion of cornea.Collagen cross linking using Riboflavin/ultraviolet A,paraformaldehyde and glutaraldehyde has been widely used to treat keratoconus,but these techniques have several clinical complications.This study aimed to develop a rapid,safer,less toxic and more effective method to increase the corneal stiffness hence treating keratoconus by using EDC/NHS coupling with pimelic acid(PA)as cross-linkers.Methods:The viability of corneal epithelial and endothelial cells was examined using Alamar blue.The corneal collagen and tissue integrity were evaluated with Masson and hematoxylin and eosin stains respectively.Uniaxial tensile testing was conducted to determine the tissue stiffness.We further assessed the effective penetration depth of cross-linking by fluorescence dye and confocal microscopy.TUNEL assay was performed to detect the damaged DNA fragments in the presence of PA.Results:The effect of PA solution on corneal cross-linking showed a significant increase in corneal rigidity without affecting the epithelium integrity under neutralized pH condition,while DEC/NHS alone did not induce the mechanical property.The penetration depth showed consistent results with increased stiffness,which could be affected by the parameters including pH condition,coupling with or without PA.In addition,PA significantly decreased the percentage of TUNEL-positive cells compared to that of EDC/NHS only condition.The cytotoxic effect to endothelium was considered minimal and protected in the presence of PA.Conclusions:We demonstrated PA as a potential alternative for cross-linking in the model of whole eye with intact epithelium and its protective role on endothelium.The administration of this chemical cross-linker stands as an extremely promising technique for the treatment of corneal keratoconus.
基金This study has been financed in part by the Network for Cooperative Research in Health“OFTARED”—Reference:RD16/0008/0012.Funded by Instituto de Salud Carlos III and co-funded by the European Regional Development Fund(ERDF),Project“A way to make Europe”.
文摘Background The purpose of the study was to determine the advantages and disadvantages of epi-on corneal cross-linking(CXL)techniques compared with standard epi-off CXL.Methods We searched MEDLINE and EMBASE for randomized controlled trials(RCTs)and non-randomized studies of interventions(NRSIs)and we evaluated the selected papers according to the Cochrane risk of bias tool.We considered,as primary outcomes,average Kmax flattening,changes in uncorrected and corrected distance visual acuity(UDVA and CDVA);as secondary outcomes,we considered changes in pachymetry values and endothelial cell density(ECD).We also investigated adverse events related to the treatments and treatment failure.Meta-analysis was conducted with a fixed or random-effects model using weighted mean difference(MD)with 95%confidence interval(CI)as the effect size.Results A total of 15 studies were included and among these 15 trials,9 were RCTs and 6 were NRSIs,but only 4 studies showed no high risk of bias and were included in this meta-analysis.Our analysis revealed significant postoperative differences in CDVA(MD=0.07;95%CI 0.04 to 0.10;P<0.001),and no significative differences in UDVA,Kmax,central corneal thickness(CCT)and ECD(P>0.05).Epi-on CXL protocol was found to be significantly less prompt to have risks of delay in epithelial healing(P=0.035)and persistent stromal haze(P=0.026).Conclusion Epi-on CXL is as effective as epi-off CXL.Except for a higher significant improvement in CDVA with current epi-on protocols,our meta-analysis demonstrates that epi-on and epi-off CXL have comparable effects on visual,topographic,pachymetric,and endothelial parameters.Epi-on CXL has clinical advantages in terms of comfort and avoidance of complications as it reduces the risk of developing delay in epithelial healing and persistent stromal haze.
基金Supported by Shandong Province Medical Staff Science and Technology Innovation Program Project(No.SDYWZGKCJH2022021).
文摘AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.
文摘Since the late 1990s corneal crosslinking(CXL)has been proposed as a new possibility to stop progression of keratoconus or secondary corneal ectasia,with the promising aim to prevent progressive visual loss due to the evolution of the pathology and to delay or avoid invasive surgical procedures such as corneal transplantation.The possibility of strengthening corneal tissue by means of a photochemical reaction of corneal collagen by the combined action of Riboflavin and ultraviolet A irradiation(UVA),radically modified the conservative management of progressive corneal ectasia.This is a review of the state of the art of CXL,reporting basic and clinical evidence.The paper describes basic principles,advantages and limits of different CXL techniques and possible future evolution of the procedure.
文摘Corneal collagen cross-linking(CXL)is a therapeutic procedure aiming at increasing the corneal stiffness in the keratoconus eyes by induction of cross-links within the extracellular matrix.It is achieved by ultraviolet-A(370 nm)irradiation of the cornea after saturation with the photosensitizer riboflavin.In the conventional CXL protocol,a minimum de-epithelialized corneal thickness of 400μm is recommended to avoid potential irradiation damage to the corneal endothelium.In advanced keratoconus,however,stromal thickness is often lower than 400μm,which limits the application of CXL in that category.Efforts have been undertaken to modify the conventional CXL procedure to be applicable in thin corneas.The current review discusses different techniques employed to achieve this end and their results.The overall safety and efficacy of the modified CXL protocols are good,as most of them managed to halt the progression of keratectasia without postoperative complications.However,the evidence of safety and efficacy in the use of modified CXL protocols is still limited to few studies with few patients involved.Controlled studies with long-term follow-up are required to confirm the safety and efficacy of the modified protocols.
基金supported by National Natural Science Foundation of China(52103029 and 51903075).
文摘Polyimide(PI)is a promising electronic packaging material,but it remains challenging to obtain an all-organic PI hybrid film with decreased dielectric constant and loss without modifying the monomer.Herein,a series of allorganic PI hybrid films were successfully prepared by introducing the covalent organic framework(COF),which could induce the formation of the cross-linking structure in the PI matrix.Due to the synergistic effects of the COF fillers and the cross-linking structure,the PI/COF hybrid film containing 2 wt%COF exhibited the lowest dielectric constant of 2.72 and the lowest dielectric loss(tanδ)of 0.0077 at 1 MHz.It is attributed to the intrinsic low dielectric constant of COF and a large number of mesopores within the PI.Besides,the cross-linking network of PI prevents the molecular chains from stacking and improves the fraction of free volume(FFV).The molecular dynamics simulation results are well consistent with the dielectric properties data.Furthermore,the PI/COF hybrid film with 5 wt%COF showed a significant enhancement in breakdown strength,which increased to 412.8 kV/mm as compared with pure PI.In addition,the PI/COF hybrid film achieve to reduce the dielectric constant and thermal expansion coefficient(CTE).It also exhibited excellent thermal,hydrophobicity,and mechanical performance.The all-organic PI/COF hybrid films have great commercial potential as next-generation electronic packaging materials.
文摘Objective The aim of this review is to comprehensively and unbiasedly summarize the improvements in the techniques for classical corneal collagen cross-linking (CXL) by covering the reasons for this improvement, measure, and effect to approach the future direction of the CXL. Data sources All articles used in this review were mainly retrieved from the PubMed database. Study selection Original articles and reviews were selected if they were related to the improvement in the technique of classical CXL. Data were mainly extracted from 94 articles, which are listed in the reference section of this review. Results This innovative research involves every step such as instrument preparation, epithelial management, riboflavin instillation, and UVA irradiation. These clinical and experimental results seem promising. Conclusions CXL treatment is the only recent promising method for preventing the progress of keratoconus. The limitations and potential complications that accompany classical CXL such as corneal thickness limitations, ultraviolet-A (UVA) light injury, and the impact of de-epithelialization encourage people to research new improvements in techniques. While this research needs to be further investigated, we hope our review can help related researchers and patients.
基金funded by the Indonesia Toray Science Foundation(No.:001/I/ITSF/SEK/2019).
文摘This research paper describes the synthesis of thermo-reversible cross-linking of sago starch by grafting a furan pendant group(methyl 2-furoate)onto the starch backbone,followed by a Diels-Alder(DA)reaction of the furan functional group with 1,1′-(methylenedi-4,1-phenylene)bismaleimide(BM).The proof of principles was provided by FTIR and 1H-NMR analyses.The relevant FTIR peaks are the carbonyl peak(υC=O sym)at 1721 cm^(−1);the two peaks appeared after DA cross-linking,i.e.,at 1510 cm^(−1)(corresponding toυCH=CH BM aromatic rings,stretching vibrations),and at 1173 cm^(−1)(assigned to cycloadduct(C-O-C,δDA ring))while the^(1)H-NMR result shows evidence for the presence of a furan ring in the starch matrices(in the range ofδ6.3-7.5 ppm).The crosslinked starch product is indeed thermally reversible,as is evident from the appearance of exothermal(DA,temperature range of 50℃-70℃)and endothermal(retro DA,temperature range of 125℃-150℃)transitions in the DSC thermograms.This paper not only proves the thermal reversibility but also demonstrates that the final product properties(chemical,morphology,and thermal stability)can be tuned by varying the annealing temperature,BM intake,and reaction time.
基金granted by the National Key R&D Program of China (2021YFD21001005)National Natural Science Foundation of China (31972102,32101980)+1 种基金Special key project of Chongqing technology innovation and application development (cstc2021jscx-cylhX0014)Chongqing Technology Innovation and Application Development Special Project (cstc2021jscx-tpyzxX0014)。
文摘This study aimed to characterize and identify calcium-chelating peptides from rabbit bone collagen and explore the underlying chelating mechanism.Collagen peptides and calcium were extracted from rabbit bone by instant ejection steam explosion(ICSE)combined with enzymatic hydrolysis,followed by chelation reaction to prepare rabbit bone peptide-calcium chelate(RBCP-Ca).The chelating sites were further analyzed by liquid chromatography-tandem mass(LC-MS/MS)spectrometry while the chelating mechanism and binding modes were investigated.The structural characterization revealed that RBCP successfully chelated with calcium ions.Furthermore,LC-MS/MS analysis indicated that the binding sites included both acidic amino acids(Asp and Glu)and basic amino acids(Lys and Arg),Interestingly,three binding modes,namely Inter-Linking,Loop-Linking and Mono-Linking were for the first time found,while Inter-Linking mode accounted for the highest proportion(75.1%),suggesting that chelation of calcium ions frequently occurred between two peptides.Overall,this study provides a theoretical basis for the elucidation of chelation mechanism of calcium-chelating peptides.