Riboflavin concentration in corneal stroma after intracameral injection

AIM: To evaluate the enrichment of riboflavin in the corneal stroma after intracameral injection to research the barrier ability of the corneal endothelium to riboflavin in vivo.METHODS: The right eyes of 30 New Zealand white rabbits were divided into three groups. Different concentrations riboflavin-balanced salt solutions(BSS)were injected into the anterior chamber(10 with 0.5%, 10 with 1%, and 10 with 2%). Eight corneal buttons of 8.5mm in diameter from each group were dissected at 30 min after injection and the riboflavin concentrations in the corneal stroma were determined using high-performance liquid chromatography(HPLC) after removing the epithelium and endothelium. The other two rabbits in every group were observed for 24 h and sacrificed. As a comparison, the riboflavin concentrations from 16 corneal stromal samples were determined using HPLC after instillation of 0.1% riboflavin-BSS solution for30 min on the corneal surface(8 without epithelium and 8with intact epithelium).RESULTS: The mean riboflavin concentrations were11.19, 18.97, 25.08, 20.18, and 1.13 μg/g for 0.5%, 1%, 2%,de-epithelialzed samples, and the transepithelial groups,respectively. The color change of the corneal stroma and the HPLC results showed that enrichment with riboflavin similar to classical de-epithelialized corneal collagen crosslinking(CXL) could be achieved by intracameral 1%riboflavin-BSS solution after 30min; the effect appeared to be continuous for at least 30 min.CONCLUSION: Riboflavin can effectively penetrate the corneal stroma through the endothelium after an intracameral injection in vivo, so it could be an enhancing method that could improve the corneal riboflavin concentration in transepithelial CXL.

Different compression sutures combined with intracameral air injection for acute corneal hydrops

·AIM:To evaluate the efficacy and safety of full-thickness sutures combined with intracameral air injection(FTS-AI)versus pre-Descemet’s membrane sutures combined with intracameral air injection(PDS-AI)in the management of acute corneal hydrops in keratoconus.·METHODS:The research included 8 patients(8 eyes)suffering from acute corneal hydrops caused by keratoconus.Four patients were randomly assigned to FTS-AI.And the other four were randomly assigned to PDS-AI.Corneal oedema,visual acuity,corneal thickness were assessed during follow-up.·RESULTS:The demographics,preoperative duration of symptoms and severity of corneal hydrops between the two groups were not significantly different.The mean corneal oedema resolution time after FTS-AI and PDSAI were 11±1.15 and 15±1.41 d,respectively(P=0.005).The maximum corneal thickness of the scarred region decreased in both groups at one week postoperatively(P<0.05).No obvious difference was found in the mean maximal corneal thickness between the two groups postoperatively.The BCVA improved significantly after FTS-AI and PDS-AI at three months postoperatively.No obvious difference was found in the BCVA after FTS-AI and PDS-AI at three months postoperatively.·CONCLUSION:FTS-AI and PDS-AI are safe and effective therapies to accelerate the resolution of corneal oedema in acute corneal hydrops secondary to keratoconus.Despite faster resolution of corneal oedema in the FTS-AI group,we recommend PDS-AI to avoid potential endothelium cell damage.

Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty

AIM:To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty(PKP).METHODS:In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin0.5% ophthalmic solution(0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity(BCVA), corneal endothelial cell count(ECC), and central corneal thickness(CCT).RESULTS:Fifty-five patients were recruited(26 males,29 females). The mean age was 54.36±4.97y(range 45-64y).All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively,which was statistically significant(P 【0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33 ±1.01 s. The mean ECC was 2340.20 cells/mm2 preoperatively and 1948.75 cells/mm21 mo postoperatively(P 【0.001). The increase of21.09 μm in postoperative pachymetry 1mo after surgery was statistically significant(P 【0.001).CONCLUSION:Nountowardeffectswereobservedafter intracameral injection of moxifloxacin(0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.