Silicon-dried corneal graft crosslinking as a means to increase the effectiveness of urgent keratoplasty
https://doi.org/10.21516/2072-0076-2023-16-4-92-96
Abstract
Purpose: to evaluate the effectiveness of silicon-dried cornea, previously subjected to corneal collagen UVA crosslinking, for urgent keratoplasty.
Material and methods. 28 patients (16 males, 12 females), diagnosed with perforating corneal ulcer of various etiologies, underwent penetrating keratoplasty for eye-preserving purposes. 14 patients (the main group) underwent transplantation of a silicon-dried cornea, previously subjected to corneal collagen crosslinking according to the standard (Dresden) protocol while the remaining 14 patients (comparison group) underwent penetrating keratoplasty with not pre-treated silicon-dried cornea. In the postoperative period, we measured the time of primary complete epithelization of the graft and assessed the presence/absence of ulcers and erosions of the corneal graft 1, 3, 6 and 12 months after the discharge from the hospital. For this purpose, all patients underwent corneal biomicroscopy with corneal surface preliminary stained with a 1% sodium fluorescein solution.
Results. Complete epithelization in both the main group and the comparison group was found to take place, on average, at the same time after surgery. However, over the entire observation period, the main group showed fewer relapses of ulcers and corneal graft erosions than the comparison group.
Conclusion. The use of silicon-dried cornea, subjected to corneal collagen cross-linking, increases the effectiveness of perforated corneal ulcer treatment in emergency surgical care.
About the Authors
S. V. Flora
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Sergey V. Flora — ophthalmologist, department of traumatology and
reconstructive surgery
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
E. V. Chentsova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Ekaterina V. Chentsova — Dr. of Med. Sci., professor, head of the department of traumatology and reconstructive surgery
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
T. V. Tselaya
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Tatyana V. Tselaya — PhD student, department of traumatology and reconstructive surgery
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062, Russia
References
1. Neroev V.V., Yani E.V., Iomdina E.N., et al. Treatment of corneal ulcers by local ultraviolet crosslinking (an experimental study). Russian Ophthalmological Journal. 2020; 13 (4): 48–57 (In Russ.). doi: 10.21516/2072-0076-2020-13-4-48-57
2. Chentsova E.V., Verigo E.N., Makarov P.V., Khazamova A.I. Crosslinking in the complex treatment of corneal ulceration and corneal grafting. Russian ophthalmological journal. 2017; 10 (3): 93–100 (In Russ.). https://doi.org/10.21516/2072-0076-2017-10-3-93-100
3. Yani E.V., Iomdina E.N., Pozdnyakova V.V., Golikova V.A., Seliverstova K.E. Treatment of protracted corneal ulcers with ultraviolet crosslinking of corneal collagen. Clinical cases. Russian ophthalmological journal. 2021; 14 (3): 106–12 (In Russ.). doi: 10.21516/2072-0076-2021-14-3-106-12
4. Moroz Z.I., Malyugin B.E., Gorokhova М.V., Kovschun E.V. UV cross-linked donor corneas for penetrating keratoplasties in corneal perforations. Ophthalmosurgery. 2014; 2: 29–32 (in Russ.)
5. Flora S.V., Chentsova E.V., Iomdina E.N. Crosslinking of the Bioplast plastic material as a means of increasing its biomechanical stability and the effectiveness of keratoplasty for corneal ulcers. Russian ophthalmological journal. 2021; 14 (2): 36–41 (In Russ.). https://doi.org/10.21516/2072-0076-2021-14-2-36-41
6. Pleskova A.V., Katargina L.A., Iomdina E.N., et al. First results of clinical application of ultraviolet corneal collagen crosslinking in the treatment of corneal and graft ulcers in children. Oftal'mologiya. 2022; 19 (3): 692–8 (In Russ.). https://doi.org/10.18008/1816-5095-2022-3-692-698
7. Flora S.V., Iomdina E.N., Chentsova E.V. Effect of UVA crosslinking on the biomechanical properties of the lyophilized cornea «Bioplast». Sovremennye tekhnologii v oftal’mologii. 2020; 4 (35): 84–5 (In Russ.). doi: 10.25276/2312-4911-2020-4-84-85
8. Flora S.V., Chentsova E.V., Iomdina E.N. Method for preparing material for penetrating keratoplasty. Patent RF 2729927, 13.08.2020 (In Russ.).
9. Gavrilova N.A., Revishchin A.V., Borzenok S.A., et al. Pathogenetic mechanisms of epithelialization and formation of persistent ulcers of the graft in patients with destructive corneal processes after penetrating keratoplasty. Ophthalmosurgery. 2018; 2: 36–41 (In Russ). doi: 10.25276/0235-4160-2018-2-36-41
10. Thiese MS, Ronna B, Ott U. P value interpretations and considerations. J Thorac Dis. 2016; 8 (9): E928–E931. doi: 10.21037/jtd.2016.08.16
11. G mez-de-Mariscal E., Guerrero V., Sneider A., et al. Use of the p-values as a size-dependent function to address practical differences when analyzing large datasets. Sci Rep. 2021; 11, 20942. https://doi.org/10.1038/s41598-021-00199-5
Review
For citations:
Flora S.V., Chentsova E.V., Tselaya T.V. Silicon-dried corneal graft crosslinking as a means to increase the effectiveness of urgent keratoplasty. Russian Ophthalmological Journal. 2023;16(4):92-96. (In Russ.) https://doi.org/10.21516/2072-0076-2023-16-4-92-96
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