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Treatment of corneal ulcers by local ultraviolet crosslinking (an experimental study)

https://doi.org/10.21516/2072-0076-2020-13-4-48-57

Abstract

Purpose: to compare the effectiveness of corneal ulcer treatment by antibiotic therapy and local ultraviolet crosslinking in a clinical and morphological experimental study using the new Crosscor device. Material and methods. The study was performed on 15 rabbits (30 eyes) with a model of corneal ulceration caused by Staphylococcus aureus. Rabbits were divided into 3 groups of 5 specimens each (10 eyes). Group 1 received local ultraviolet A range (UVA) crosslinking (CL) of the cornea using the Crosscor device (3 procedures lasting 5, 6 and 6 minutes each were given with intervals of three days). In group 2, CL was combined with antibacterial treatment (AB): instillations of tobramycin 0.3 % and ofloxacin ointment 3 mg / g were given 4 times a day for 14 days. In the control group, only AB treatment was given. The dynamics of inflammation, the intensity of turbidity and the size of the corneal ulcer were evaluated using biomicroscopy, fluorescein test, photoregistration of the anterior part of the eye, and according to a point system. Morphological changes in the cornea were determined using light microscopy (Leica with a DFC 420C digital camera). Results. In group 1 (CL) complete healing of the ulcer defect was noted on the 9th day of observation; in group 2 (CL + AB), the diameter of the corneal ulcer was reduced to 1.6 ± 0.5 mm, in the control group (AB) it was reduced to 1.9 ± 0.3 mm (p < 0.05). The total score of inflammatory changes on day 9 in the 1st group was 0.8 ± 1.3, in the 2nd group, 3.6 ± 0.8, and in the control group, 3.7 ± 0.4 (p < 0.05). On day 9, in all cases of the 1st group, a slight clouding of the cornea was formed (0–-1 point); in the 2nd group and in the control group in 90 % of cases a rough clouding of the cornea with vascularization was formed (3 points). Morphological examination of the eyes showed that only in the 1st group avascular scars with an ordered arrangement of fibrous tissue fibrils were formed. Conclusion. The data obtained indicate a significantly higher efficiency of corneal ulcer treatment by local UVA crosslinking using Crosscor as compared with antibiotic therapy.

About the Authors

V. V. Neroev
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Vladimir V. Neroev — Academician of RAS, Dr. of Med. Sci., professor, director

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062



E. V. Yani
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Elena V. Yani — Cand. of Med. Sci., department of infectious and allergic eye diseases, head

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062



E. N. Iomdina
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Elena N. Iomdina — Dr. of Biol. Sci., professor principal researcher department of refraction pathology, binocular vision and ophthalmoergonomics

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062



I. P. Khoroshilova-Maslova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Inna P. Khoroshilova-Maslova — Dr. of Med. Sci., professor, department of the eye pathologic anatomy and histology, head

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062



V. A. Golikova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation

Viktorija A. Golikova — PhD student, department of infectious and allergic eye diseases

14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062



A. V. Kiryukhin
Research and Development Center of Yelatma Instrument Making Enterprise, JSC
Russian Federation

Anton V. Kiryukhin — engineer

building B, 48, Vysokovoltnaya St., Ryazan, 390029



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Neroev V.V., Yani E.V., Iomdina E.N., Khoroshilova-Maslova I.P., Golikova V.A., Kiryukhin A.V. Treatment of corneal ulcers by local ultraviolet crosslinking (an experimental study). Russian Ophthalmological Journal. 2020;13(4):48-57. (In Russ.) https://doi.org/10.21516/2072-0076-2020-13-4-48-57

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ISSN 2072-0076 (Print)
ISSN 2587-5760 (Online)