The authors have no acknowledgements.

这些协议遵循我院的人类研究伦理委员会的指导方针。 1.常规角膜胶原蛋白CXL（C-CXL） 1.患者准备<ol><li>在手术前5天，放了一天的治疗眼1％毛果芸香碱滴两次。 </li><li>在手术室，在无菌条件下，趴在他/她的背部病人。 </li><li>辖表面麻醉，如奥布卡0.4％。 </li><li>清洁眼睛和眼睛周围的皮肤用碘防腐剂两次。 </li><li>使用盖窥器，以保持眼睛睁开。 </li></ol> 2.上皮去除<ol><li>马可中心9.0毫米用圆圈标记角膜角膜。 </li><li>取出角膜上皮用生硬的抹刀中央7.0至9.0毫米乘机械清除。 </li></ol> 3.核黄素应用<ol><li>适用于日与20％葡聚糖0.1％核黄素<html> Ë角膜每分钟为20分钟。 </li></ol> 4. UVA照射<ol><li>照射具有370nm的波长的UVA光的角膜以3毫瓦/厘米2（5.4焦耳/厘米2表面剂量）的辐照，并在一个5厘米的工作距离为30分钟。 </li></ol><img alt="图1" src="/files/ftp_upload/53119/53119fig1.jpg" /> 图1：在C-CXL UVA照射的角膜以3毫瓦/厘米2（5.4焦耳/厘米2表面剂量）的辐照，并在一个5厘米的工作距离30分钟照射370nm的波长的UVA光。 <a href="https://www.jove.com/files/ftp_upload/53119/53119fig1large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <ol start="2"><li>在辐照过程中，应用核黄素角膜每隔5分钟滴。 </li><li>在辐照过程中，添加表面麻醉（奥布卡0.4％），如果有必要的。 </li></ol>手术“&gt; 5。完<ol><li>把抗生素滴眼液（妥布霉素0.3％）和人工泪液（透明质酸下降0.18％），到运营的眼睛。 </li><li>将软绷带隐形眼镜在手术结束，直到再上皮化完成。再上皮化通常需要3天。 </li><li>处方止痛药如对乙酰氨基酚（500毫克）加可待因（30毫克），每日6药片。 </li><li>后角膜再上皮，发起局部治疗与类固醇（地塞米松局部为1mg / ml），并继续进行3-4周。此外，使用人工泪液，每天4次，1个月。 </li></ol> 2.加速角膜胶原CXL（A-CXL） 1.患者准备<ol><li>在手术前5天，放了一天的治疗眼1％毛果芸香碱滴两次。 </li><li>在手术室，在无菌条件下，趴在他/她的背部病人。 </li><li>辖表面麻醉，如奥布卡0.4％。 </li><li>清洁电子你们和眼睛周围的碘消毒剂皮肤的两倍。 </li><li>使用盖窥器，以保持眼睛睁开。 </li></ol> 2.上皮去除<ol><li>标记中央9.0毫米角膜的带圈角膜标记</li><li>取出角膜上皮用生硬的抹刀中央7.0至9.0毫米乘机械清除。 </li></ol> 3.核黄素应用<ol><li>在角膜上施加0.1％的核黄素，而不葡聚糖每2分钟进行10分钟。 </li></ol> 4. UVA照射<ol><li>照射具有370nm的波长的UVA光的角膜以30毫瓦/厘米2（5.4焦耳/厘米2表面剂量），并在一个5厘米的工作距离为3分钟的辐照。 </li><li>在照射，增加局部麻醉（oxybuproca＆＃239，是ne 0.4％），如果有必要的。 </li></ol> 5.结束手术<ol><li>将抗生素滴眼液（妥布霉素0.3％）和人工泪液（透明质酸下降0<html> 0.18％）进入操作眼睛。 </li><li>将软绷带隐形眼镜在手术结束，直到再上皮化完成。再上皮化通常需要3天。 </li><li>处方止痛药如对乙酰氨基酚（500毫克）加可待因（30毫克），每日6药片。 </li><li>后角膜再上皮，发起局部治疗与类固醇（地塞米松局部为1mg / ml），并继续进行3-4周。此外，使用人工泪液，每天4次，1个月。 </li></ol> 3，离子透入（I-CXL） 1.患者准备<ol><li>在手术前5天，放了一天的治疗眼1％毛果芸香碱滴两次。 </li><li>在手术室，在无菌条件下，趴在他/她的背部病人。 </li><li>辖表面麻醉，如奥布卡0.4％。 </li><li>清洁眼睛和眼睛周围的皮肤用碘防腐剂两次。 </li><li>使用盖窥器，以保持眼睛睁开。 </li></ol><html> _step“&gt; 2，放置离子电渗装置。 <ol><li>应用粘被动电极的手术视野下的额头。 </li><li>应用活性电极，一个吸环，到打开眼。释放所述抽吸之前围绕角膜的周边上的吸环。 </li></ol><img alt="图2" src="/files/ftp_upload/53119/53119fig2.jpg" /> 图2.离子导入装置，该无源电极施加在手术视野下的额头和活性电极，一个吸环，适用于开放的眼睛。 <a href="https://www.jove.com/files/ftp_upload/53119/53119fig2large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> 3.核黄素应用<ol><li>填写吸入环与低渗0.1％核黄素无葡聚糖。 </li></ol><html> JPG“/&gt; 在I-CXL图3.核黄素的应用 。吸入环充满了低渗0.1％核黄素没有葡聚糖。 <a href="https://www.jove.com/files/ftp_upload/53119/53119fig3large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> <ol start="2"><li>启动电流在0.2 mA和逐步增加至1.0毫安的5分钟（图4），总离子电渗疗法的时间。 </li></ol><img alt="图4" src="/files/ftp_upload/53119/53119fig4.jpg" /> 图4.离子导入设备核黄素渗透的电流最初是0.2 mA和逐渐增加至1.0毫安。总离子导入时间为5分钟。 <a href="https://www.jove.com/files/ftp_upload/53119/53119fig4large.jpg" target="_blank">请点击此处查看该图的放大版本。</a> EP“&gt; 4。UVA照射<ol><li>照射具有370nm的波长的UVA光的角膜以10毫瓦/厘米2（5.4焦耳/厘米2表面剂量），并在一个5厘米的工作距离为9分钟的辐照。 </li><li>在照射，增加局部麻醉（oxybuproca＆＃239，是ne 0.4％），如果有必要的。 </li></ol> 5.结束手术<ol><li>将抗生素滴眼液（妥布霉素0.3％）和人工泪液（透明质酸下降0.18％），到运营的眼睛。 </li><li>处方止痛药如对乙酰氨基酚（500毫克）加可待因（30毫克），每日6药片。 </li><li>手术后，发起局部治疗与类固醇（地塞米松局部为1mg / ml）和持续3-4周。此外，使用人工泪液，每天4次，1个月。 </li></ol>

<ol>
	<li>Rabinowitz, Y. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Keratoconus.">Keratoconus.</a> Surv Ophthalmol. 42 (4), 297-319 (1998).</li><li>Tuori, A. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+immunohistochemical+composition+of+corneal+basement+membrane+in+keratoconus.">The immunohistochemical composition of corneal basement membrane in keratoconus.</a> Curr Eye Res. 16 (8), 792-801 (1997).</li><li>Wollensak, G., Spoerl, E., Seiler, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Riboflavin/ultraviolet-A-induced+collagen+cross-linking+for+the+treatment+of+keratoconus.">Riboflavin/ultraviolet-A-induced collagen cross-linking for the treatment of keratoconus.</a> Am J Ophthalmol. 135 (5), 620-627 (2003).</li><li>Raiskup-Wolf, F., Hoyer, A., Spoerl, E., Pillunat, L. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Collagen+cross-linking+with+riboflavin+and+ultraviolet-A+light+in+keratoconus:+long-term+results.">Collagen cross-linking with riboflavin and ultraviolet-A light in keratoconus: long-term results.</a> J Cataract Refract Surg. 34 (5), 796-801 (2008).</li><li>Vinciguerra, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=topographic,+tomographic,+and+aberrometric+analysis+of+keratoconic+eyes+undergoing+corneal+cross-linking.">topographic, tomographic, and aberrometric analysis of keratoconic eyes undergoing corneal cross-linking.</a> Ophthalmology. 116 (3), 369-378 (2009).</li><li>Caporossi, A., Mazzotta, C., Baiocchi, S., Caporossi, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+results+of+riboflavin+ultraviolet-A+corneal+collagen+cross-linking+for+keratoconus+in+Italy:+the+Siena+eye+cross+study.">Long-term results of riboflavin ultraviolet-A corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study.</a> Am J Ophthalmol. 149 (4), 585-593 (2010).</li><li>Greenstein, S. A., Fry, K. L., Hersh, P. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+topography+indices+after+corneal+collagen+cross-linking+for+keratoconus+and+corneal+ectasia:+one-year+results.">Corneal topography indices after corneal collagen cross-linking for keratoconus and corneal ectasia: one-year results.</a> J Cataract Refract Surg. 37 (7), 1282-1290 (2011).</li><li>Ghanem, R. C., Santhiago, M. R., Berti, T., Netto, M. V., Ghanem, V. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Topographic+corneal+wavefront,+and+refractive+outcomes+2+years+after+collagen+cross-linking+for+progressive+keratoconus.">Topographic corneal wavefront, and refractive outcomes 2 years after collagen cross-linking for progressive keratoconus.</a> Cornea. 33 (1), 43-48 (2014).</li><li>Koller, T., Mrochen, M., Seiler, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complication+and+failure+rates+after+corneal+cross-linking.">Complication and failure rates after corneal cross-linking.</a> J Cataract Refract Surg. 35 (8), 1358-1362 (2009).</li><li>Rocha, K. M., Ramos-Esteban, J. C., Qian, Y., Herekar, S., Krueger, R. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparative+study+of+riboflavin-UVA+cross-linking+and+&#8220;flash-linking&#8221;+using+surface+wave+elastometry.">Comparative study of riboflavin-UVA cross-linking and &#8220;flash-linking&#8221; using surface wave elastometry.</a> J Refract Surg. 24 (7), 748-751 (2008).</li><li>Caporossi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transepithelial+corneal+collagen+crosslinking+for+progressive+keratoconus:+24-month+clinical+results.">Transepithelial corneal collagen crosslinking for progressive keratoconus: 24-month clinical results.</a> J Cataract Refract Surg. 39 (8), 1157-1163 (2013).</li><li>Bikbova, G., Bikbov, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transepithelial+corneal+collagen+cross-linking+by+iontophoresis+of+riboflavin.">Transepithelial corneal collagen cross-linking by iontophoresis of riboflavin.</a> Acta Ophthalmol. 92 (1), 30-34 (2014).</li><li>Efron, N., Hollingsworth, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+perspectives+on+keratoconus+as+revealed+by+corneal+confocal+microscopy.">New perspectives on keratoconus as revealed by corneal confocal microscopy.</a> Clin Exp Optom. 91 (1), 34-55 (2008).</li><li>Patel, D. V., McGhee, C. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mapping+the+corneal+sub-basal+nerve+plexus+in+keratoconus+by+in+vivo+laser+scanning+confocal+microscopy.">Mapping the corneal sub-basal nerve plexus in keratoconus by in vivo laser scanning confocal microscopy.</a> Invest Ophthalmol Vis Sci. 47 (4), 1348-1351 (2006).</li><li>Ku, J. Y., Niederer, R. L., Patel, D. V., Sherwin, T., McGhee, C. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laser+scanning+in+vivo+confocal+analysis+of+keratocyte+density+in+keratoconus.">Laser scanning in vivo confocal analysis of keratocyte density in keratoconus.</a> Ophthalmology. 115 (5), 845-850 (2008).</li><li>Mazzotta, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+healing+after+riboflavin+ultraviolet-A+collagen+cross-linking+determined+by+confocal+laser+scanning+microscopy+in+vivo:+early+and+late+modifications.">Corneal healing after riboflavin ultraviolet-A collagen cross-linking determined by confocal laser scanning microscopy in vivo: early and late modifications.</a> Am J Ophthalmol. 146 (4), 527-533 (2008).</li><li>Seiler, T., Hafezi, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+cross-linking-induced+stromal+demarcation+line.">Corneal cross-linking-induced stromal demarcation line.</a> Cornea. 25 (9), 1057-1059 (2006).</li><li>Doors, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+anterior+segment+optical+coherence+tomography+to+study+corneal+changes+after+collagen+cross-linking.">Use of anterior segment optical coherence tomography to study corneal changes after collagen cross-linking.</a> Am J Ophthalmol. 148 (6), 844-851 (2009).</li><li>Mazzotta, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Treatment+of+progressive+keratoconus+by+riboflavin-UVA-induced+cross-linking+of+corneal+collagen:+ultrastructural+analysis+by+Heidelberg+Retinal+Tomograph+II+in+vivo+confocal+microscopy+in+humans.">Treatment of progressive keratoconus by riboflavin-UVA-induced cross-linking of corneal collagen: ultrastructural analysis by Heidelberg Retinal Tomograph II in vivo confocal microscopy in humans.</a> Cornea. 26 (4), 390-397 (2007).</li><li>Kymionis, G. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Correlation+of+the+corneal+collagen+cross-linking+demarcation+line+using+confocal+microscopy+and+anterior+segment+optical+coherence+tomography+in+keratoconic+patients.">Correlation of the corneal collagen cross-linking demarcation line using confocal microscopy and anterior segment optical coherence tomography in keratoconic patients.</a> Am J Ophthalmol. 157 (1), 110-115 (2014).</li><li>Yam, J. C., Chan, C. W., Cheng, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+collagen+cross-linking+demarcation+line+depth+assessed+by+Visante+OCT+After+CXL+for+keratoconus+and+corneal+ectasia.">Corneal collagen cross-linking demarcation line depth assessed by Visante OCT After CXL for keratoconus and corneal ectasia.</a> J Refract Surg. 28 (7), 475-481 (2012).</li><li>Jordan, C., Patel, D. V., Abeysekera, N., McGhee, C. .. N. .. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+confocal+microscopy+analyses+of+corneal+microstructural+changes+in+a+prospective+study+of+collagen+cross-linking+in+keratoconus.">In vivo confocal microscopy analyses of corneal microstructural changes in a prospective study of collagen cross-linking in keratoconus.</a> Ophthalmology. 121 (2), 469-474 (2014).</li><li>Touboul, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+confocal+microscopy+following+conventional,+transepithelial,+and+accelerated+corneal+collagen+cross-linking+procedures+for+keratoconus.">Corneal confocal microscopy following conventional, transepithelial, and accelerated corneal collagen cross-linking procedures for keratoconus.</a> J Refract Surg. 28 (11), 769-776 (2012).</li><li>Bouheraoua, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optical+coherence+tomography+and+confocal+microscopy+following+three+different+protocols+of+corneal+collagen-crosslinking+in+keratoconus.">Optical coherence tomography and confocal microscopy following three different protocols of corneal collagen-crosslinking in keratoconus.</a> Invest Ophthalmol Vis Sci. 55 (11), 7601-7609 (2014).</li><li>Hafezi, F., Mrochen, M., Iseli, H. P., Seiler, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Collagen+crosslinking+with+ultraviolet-A+and+hypoosmolar+riboflavin+solution+in+thin+corneas.">Collagen crosslinking with ultraviolet-A and hypoosmolar riboflavin solution in thin corneas.</a> J Cataract Refract Surg. 35 (4), 621-624 (2009).</li><li>C&#305;nar, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+accelerated+and+conventional+corneal+collagen+cross-linking+for+progressive+keratoconus.">Comparison of accelerated and conventional corneal collagen cross-linking for progressive keratoconus.</a> Cutan Ocul Toxicol. 33 (3), 218-222 (2013).</li><li>Cing&#252;, A. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transient+corneal+endothelial+changes+following+accelerated+collagen+cross-linking+for+the+treatment+of+progressive+keratoconus.">Transient corneal endothelial changes following accelerated collagen cross-linking for the treatment of progressive keratoconus.</a> Cutan Ocul Toxicol. 33 (2), 127-131 (2013).</li><li>Spoerl, E., Mrochen, M., Sliney, D., Trokel, S., Seiler, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+of+UVA-riboflavin+cross-linking+of+the+cornea.">Safety of UVA-riboflavin cross-linking of the cornea.</a> Cornea. 26 (4), 385-389 (2007).</li><li>Gokhale, N. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+endothelial+damage+after+collagen+cross-linking+treatment.">Corneal endothelial damage after collagen cross-linking treatment.</a> Cornea. 30 (12), 1495-1498 (2011).</li><li>Rootman, D. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pharmacokinetics+and+safety+of+transcorneal+iontophoresis+of+tobramycin+in+the+rabbit.">Pharmacokinetics and safety of transcorneal iontophoresis of tobramycin in the rabbit.</a> Invest Ophthalmol Vis Sci. 29 (9), 1397-1401 (1998).</li><li>Vinciguerra, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transepithelial+iontophoresis+corneal+collagen+cross-linking+for+progressive+keratoconus:+initial+clinical+outcomes.">Transepithelial iontophoresis corneal collagen cross-linking for progressive keratoconus: initial clinical outcomes.</a> J Refract Surg. 30 (11), 746-753 (2014).</li><li>Caporossi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Riboflavin-UVA-induced+corneal+collagen+cross-linking+in+pediatric+patients.">Riboflavin-UVA-induced corneal collagen cross-linking in pediatric patients.</a> Cornea. 31 (3), 227-231 (2012).</li><li>Buzzonetti, L., Petrocelli, G., Valente, P., Larossi, G., Ardia, R., Petroni, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Iontophoretic+transepithelial+corneal+cross-linking+to+halt+keratoconus+in+pediatric+cases:+15-month+follow-up.">Iontophoretic transepithelial corneal cross-linking to halt keratoconus in pediatric cases: 15-month follow-up.</a> Cornea. 34 (5), 512-515 (2015).</li><li>Baiocchi, S., Mazzotta, C., Cerretani, D., Caporossi, T., Caporossi, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Corneal+crosslinking:+riboflavin+concentration+in+corneal+stroma+exposed+with+and+without+epithelium.">Corneal crosslinking: riboflavin concentration in corneal stroma exposed with and without epithelium.</a> J Cataract Refract Surg. 35 (5), 893-899 (2009).</li><li>Wollensak, G., Iomdina, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biomechanical+and+histological+changes+after+corneal+crosslinking+with+and+without+epithelial+debridement.">Biomechanical and histological changes after corneal crosslinking with and without epithelial debridement.</a> J Cataract Refract Surg. 35 (3), 540-546 (2009).</li><li>Soeters, N., Wisse, R. P., Godefrooij, D. A., Imhof, S. M., Tahzib, N. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transepithelial+versus+epithelium-off+corneal+cross-linking+for+the+treatment+of+progressive+keratoconus:+a+randomized+controlled+trial.">Transepithelial versus epithelium-off corneal cross-linking for the treatment of progressive keratoconus: a randomized controlled trial.</a> Am J Ophthalmol. 159 (5), 821-828 (2015).</li></ol>

The authors have nothing to disclose.

用UVA照射和核黄素CXL的标准治疗为阻止圆锥角膜的进展。核黄素是光敏剂诱导化学共价键（交联）时的UVA 3照射。在角膜上，这种现象造成的胶原纤维能够提高角膜刚度之间交联。虽然这种现象被很好地描述，到现在为止已有角膜内交联的直接证据。然而，一些研究已经报道了的Kmax的稳定化从而显示出的C-CXL 3-8的有效性的步骤之后。这个效果是否是由于交联或在角膜基质等微观结...

圆锥角膜是一个双边和渐进的角膜扩张通常在一般人群1导致角膜形状的变形例中报告1 2000，从而视力下降2。圆锥角膜通常存在于早期青春期的进展，直到第三次生命不惑之年发病时通常趋于稳定，但进展可以在整个病人的生命变量。通过阻止圆锥角膜进展，交联的目的是推迟或避免角膜移植术。 到目前为止，唯一的有效和安全的治疗进步圆锥角膜证明在临床研究中是常规的角膜胶原交联（C-CXL）协议，其目的是提高刚度，从而制止圆锥角膜级数3-8。为了减少操作时间和对C-CXL其它可能的危险因素，如感染性角膜炎或基质混浊9，几种改进协议具有已有描述。首先，在加速CXL（A-CXL），UVA的更高的辐照度被传递到角膜通过减少的时间10。其次，为了避免的必要性上皮清创，跨上皮的方法已被采用。遗憾的是，他们已经时比现有协议11有限的成功。最近的跨上皮方法CXL期间角膜核黄素递送是离子电渗疗法（Ⅰ-CXL），但这种治疗方法的严格评价还未执行的12。离子电渗疗法是一种在其中一个小电流被施加穿过组织来提高离子化的药物的渗透非侵入性技术。在CXL通过离子电渗，核黄素被离子化通过上皮渗透角膜。 体内共焦显微镜（IVCM）是成像，可以突出显示异常的角膜中的疾病，如圆锥角膜13的细胞改变角膜的方法。事实上，IVCM已经证明改建在圆锥角膜的角膜所有层与在子基底神经丛的密度特定还原和基质角膜13-15。加，IVCM已被证明是对后的C-16 CXL角膜微观结构分析非常方便。 角膜分界线被描述为一个高反射线见于眼前段光学相干断层扫描（OCT AS）1个月后的C-CXL在300微米17,18的深度。 IVCM下面的C-CXL提供有关角膜的结构改变，包括缺乏角膜基​​质的至300μm的深度信息。此无细胞区域的深度，以及在角膜基质内的分界线的深度显示在AS OCT中，似乎与CXL治疗19和角膜分界线深度的测量的有效深度的AS OCT中1到相关联的一个月后CXL已被提出作为一种有效的临床方法的CXL效力18的评价。 在本研究中，我们使用角膜基质分界线测量由AS OCT和共聚焦显微镜研究了三种不同的角膜胶原交联的协议（常规的，加速，离子电渗疗法）的效率。此外，我们使用IVCM定量分析的三种治疗后，角膜组织变化。

<table>
	<tbody>
		<tr>
			<td></td>
			<td></td>
			<td>Riboflavin&#160;&#160;&#160;&#160;&#160;&#160;&#160; Product number</td>
			<td></td>
		</tr>
		<tr>
			<td>C-CXL</td>
			<td>Sooft SPA, Montegiorgio, Italy</td>
			<td>Ricrolin&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; 468465-6</td>
			<td></td>
		</tr>
		<tr>
			<td>A-CXL</td>
			<td>Avedro Inc, Waltham, Massachusetts</td>
			<td>VibeX&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; 520-01863-006</td>
			<td></td>
		</tr>
		<tr>
			<td>I-CXL</td>
			<td>Sooft SPA, Montegiorgio, Italy</td>
			<td>Ricrolin+&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; 975481-6</td>
			<td>Passive electrode: PROTENS ELITE 4848LE/ Active electrode: IONTOFOR CXL</td>
		</tr>
		<tr>
			<td></td>
			<td></td>
			<td>UVA Machine</td>
			<td></td>
		</tr>
		<tr>
			<td>X-Vega</td>
			<td></td>
			<td></td>
			<td>UVA: 3 mW/cm2 30 min</td>
		</tr>
		<tr>
			<td>KXL System</td>
			<td></td>
			<td></td>
			<td>UVA: 30 mW/cm2 10 min</td>
		</tr>
		<tr>
			<td>X-Vega</td>
			<td></td>
			<td></td>
			<td>UVA: 10 mW/cm2 9 min</td>
		</tr>
	</tbody>
</table>

three different protocols of corneal collagen crosslinking in keratoconus: conventional, accelerated and iontophoresis

圆锥角膜是双边和渐进的角膜扩张。为了减缓其进展，角膜胶原交联（CXL）最近已推出了作为有效的治疗选择。在生物和化学科学，交联是指活性分子之间形成新的化学键。因此，角膜胶原CXL的目的是合成地增加在角膜基质中的交联的胶原原纤维之间的形成。尽管常规CXL（C-CXL）协议的效率已经在若干临床研究表明，它可能会受益于改进的过程和除去角膜上皮的持续时间。因此，为了提供两个新的和优化的CXL协议一致的评估，我们研究圆锥角膜患者谁经历了三个CXL治疗之一：离子电渗疗法（Ⅰ-CXL），加速CXL（A-CXL），和常规CXL（ C-CXL）。 A-CXL是6时间快CXL程序ü唱了十次提高的UVA辐射，但仍然包括上皮去除。离子电渗疗法是在其中一个小电流施加到改善整个角膜核黄素渗透跨上皮非侵入性技术。使用眼前段光学相干断层扫描（AS OCT）和体内共焦显微镜（IVCM），我们的结论是关于治疗穿透深度，常规CXL协议仍然用于治疗进行性圆锥形角膜的标准。加速CXL似乎是一个快速，有效，安全的替代治疗角膜薄。利用离子导入还在调查中，应该考虑更加谨慎。

<html>角膜分界线是华侨城可见的情况下，92％在301.6微米的平均深度（SD，73.6） <img alt="图5" src="/files/ftp_upload/53119/53119fig5.jpg" /> C-CXL后图5.分界线。高分辨率的角膜眼前段光学相干断层扫描（华侨城）可视化角膜基质分界线在358微米（白色箭头）1个月传统的角膜胶原蛋白交叉后，平均深度链接（C-CXL）。比例尺250微米。 <a href="https:/...

Watch this Scientific Journal Video about Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis at JoVE.com

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis

Corneal collagen cross-linking (CXL) is the only conservative treatment currently available to halt keratoconus progression by improving the biomechanical rigidity of the corneal stroma. The aim of this manuscript is to highlight the methods of three different protocols of CXL: conventional CXL (C-CXL), accelerated CXL (A-CXL), and iontophoresis CXL (I-CXL).

角膜胶原交联的圆锥角膜的三种不同的协议：常规，加速和离子导入

Keratoconus is a bilateral and progressive corneal ectasia. In order to slow down its progression, corneal collagen cross-linking (CXL) has recently been ...

three-different-protocols-corneal-collagen-crosslinking-keratoconus

Research

JoVE Journal

Medicine

19.8K 次观看.  Quinze-Vingts National Ophthalmology Hospital. Corneal collagen cross-linking (CXL) is the only conservative treatment currently available to halt keratoconus progression by improving the biomechanical rigidity of the corneal stroma. The aim of this manuscript is to highlight the methods of three different protocols of CXL: conventional CXL (C-CXL), accelerated CXL (A-CXL), and iontophoresis CXL (I-CXL).

视频: Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis

Staining Protocols for Human Pancreatic Islets

Estimates of islet area and numbers and endocrine cell composition in the adult human pancreas vary from several hundred thousand to several million and beta mass ranges from 500 to 1500 mg 1-3. With this known heterogeneity, a standard processing and staining procedure was developed so that pancreatic regions were clearly defined and islets characterized using rigorous histopathology and immunolocalization examinations. 
Standardized procedures for processing human pancreas recovered from organ donors are described in part 1 of this series. The pancreas is processed into 3 main regions (head, body, tail) followed by transverse sections. Transverse sections from the pancreas head are further divided, as indicated based on size, and numbered alphabetically to denote subsections. This standardization allows for a complete cross sectional analysis of the head region including the uncinate region which contains islets composed primarily of pancreatic polypeptide cells to the tail region.
The current report comprises part 2 of this series and describes the procedures used for serial sectioning and histopathological characterization of the pancreatic paraffin sections with an emphasis on islet endocrine cells, replication, and T-cell infiltrates. Pathology of pancreatic sections is intended to characterize both exocrine, ductular, and endocrine components. The exocrine compartment is evaluated for the presence of pancreatitis (active or chronic), atrophy, fibrosis, and fat, as well as the duct system, particularly in relationship to the presence of pancreatic intraductal neoplasia4. Islets are evaluated for morphology, size, and density, endocrine cells, inflammation, fibrosis, amyloid, and the presence of replicating or apoptotic cells using H&amp;E and IHC stains. 
The final component described in part 2 is the provision of the stained slides as digitized whole slide images. The digitized slides are organized by case and pancreas region in an online pathology database creating a virtual biobank. Access to this online collection is currently provided to over 200 clinicians and scientists involved in type 1 diabetes research. The online database provides a means for rapid and complete data sharing and for investigators to select blocks for paraffin or frozen serial sections.

This video demonstrates procedures for characterization of human pancreatic islets using hematoxylin and eosin (H&E) and immunohistochemistry (IHC). Pancreatic sections from head, body, and tail regions are stained by both H&amp;E and IHC to determine islet endocrine composition (insulin, glucagon, and pancreatic polypeptide), cell replication (Ki67), and inflammatory infiltrates (H&E, CD3). The uncinate region is localized using IHC for pancreatic polypeptide.

人类胰岛染色协议

Estimates of islet area and numbers and endocrine cell composition in the adult human pancreas vary from several hundred thousand to several million and ...

科研

医学

An Alkali-burn Injury Model of Corneal Neovascularization in the Mouse

Under normal conditions, the cornea is avascular, and this transparency is essential for maintaining good visual acuity. Neovascularization (NV) of the cornea, which can be caused by trauma, keratoplasty or infectious disease, breaks down the so called &lsquo;angiogenic privilege' of the cornea and forms the basis of multiple visual pathologies that may even lead to blindness. Although there are several treatment options available, the fundamental medical need presented by corneal neovascular pathologies remains unmet. In order to develop safe, effective, and targeted therapies, a reliable model of corneal NV and pharmacological intervention is required. Here, we describe an alkali-burn injury corneal neovascularization model in the mouse. This protocol provides a method for the application of a controlled alkali-burn injury to the cornea, administration of a pharmacological compound of interest, and visualization of the result. This method could prove instrumental for studying the mechanisms and opportunities for intervention in corneal NV and other neovascular disorders.

Neovascularization (NV) of the cornea can complicate multiple visual pathologies. Utilizing a controlled, alkali-burn injury model, a quantifiable level of corneal NV can be produced for mechanistic study of corneal NV and evaluation of potential therapies for neovascular disorders.

角膜新生血管在小鼠碱烧伤模型

Under normal conditions, the cornea is avascular, and this transparency is essential for maintaining good visual acuity. Neovascularization (NV) of the ...

A Rat Model of Ventricular Fibrillation and Resuscitation by Conventional Closed-chest Technique

A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic components of cardiopulmonary resuscitation in humans is herein described. The model was developed in 1988 and has been used in approximately 70 peer-reviewed publications examining a myriad of resuscitation aspects including its physiology and pathophysiology, determinants of resuscitability, pharmacologic interventions, and even the effects of cell therapies. The model featured in this presentation includes: (1) vascular catheterization to measure aortic and right atrial pressures, to measure cardiac output by thermodilution, and to electrically induce ventricular fibrillation; and (2) tracheal intubation for positive pressure ventilation with oxygen enriched gas and assessment of the end-tidal CO2. A typical sequence of intervention entails: (1) electrical induction of ventricular fibrillation, (2) chest compression using a mechanical piston device concomitantly with positive pressure ventilation delivering oxygen-enriched gas, (3) electrical shocks to terminate ventricular fibrillation and reestablish cardiac activity, (4) assessment of post-resuscitation hemodynamic and metabolic function, and (5) assessment of survival and recovery of organ function. A robust inventory of measurements is available that includes &#8211; but is not limited to &#8211; hemodynamic, metabolic, and tissue measurements. The model has been highly effective in developing new resuscitation concepts and examining novel therapeutic interventions before their testing in larger and translationally more relevant animal models of cardiac arrest and resuscitation.

This article describes a rat model of electrically-induced ventricular fibrillation and resuscitation by chest compression, ventilation, and delivery of electrical shocks that simulates an episode of sudden cardiac arrest and conventional cardiopulmonary resuscitation. The model enables gathering insights on the pathophysiology of cardiac arrest and exploration of new resuscitation strategies.

室颤由传统的封闭胸技术大鼠模型和复苏

A rat model of electrically-induced ventricular fibrillation followed by cardiac resuscitation using a closed chest technique that incorporates the basic ...

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in rodents, with detailed descriptions of the appropriate methods for anesthesia, the echocardiographic windows used, the imaging planes and probe orientations for image acquisition, the methods for data analysis, and the limitations of emerging technologies for the evaluation of cardiac and valvular function. Importantly, we also highlight several future areas of research in cardiac and heart valve imaging that may be leveraged to gain insights into the pathogenesis of valve disease in preclinical animal models. We propose that using a systematic approach to evaluating cardiac and heart valve function in mice can result in more robust and reproducible data, as well as facilitate the discovery of previously underappreciated phenotypes in genetically-altered and/or physiologically-stressed mice.

This protocol provides a detailed description of the echocardiographic approach for comprehensive phenotyping of heart and heart valve function in mice.

超声心动图方法和协议心脏瓣膜疾病的综合表型特征小鼠

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in ...

Induction of Accelerated Atherosclerosis in Mice: The "Wire-Injury" Model

Atherosclerosis is a proliferative fibro-inflammatory disease developing in the arterial wall, inducing a deficient blood flow or a lack of blood flow. Moreover, by rupture of the defective vascular wall, atherosclerosis induces occlusive thrombus formation, which represents the main cause of myocardial infarction or stroke and the most frequent cause of death. Despite the advances in the cardiovascular field, many questions remain unanswered, and additional basic research is essential to improve our understanding of the molecular mechanisms during atherosclerosis and its effects. Due to limited clinical studies, there is a need for representative animal models recreating atherosclerotic conditions such as neointima formation after stent implantation, balloon angioplasty, or endarterectomy. Since the mouse presents many advantages and is the most frequently used model for studying molecular processes, the current study proposes an invasive procedure of endothelial denudation, also known as the wire-injury model, which is representative of the human condition of neointima formation in arteries after revascularization procedures.

Induction of Accelerated Atherosclerosis in Mice: The &quot;Wire-Injury&quot; Model

This study describes an invasive procedure for the induction of accelerated atherosclerosis in mice. In comparison to other methods using electric- or cryo-induced injury, mechanical-induced injury mimics the human condition of restenosis after revascularization therapies and is ideal for the study of the molecular mechanisms involved.

小鼠加速动脉硬化的诱导："电线损伤"模型

Atherosclerosis is a proliferative fibro-inflammatory disease developing in the arterial wall, inducing a deficient blood flow or a lack of blood flow. ...

Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing

The murine cornea provides an excellent model to study wound healing. The cornea is the outermost layer of the eye, and thus is the first defense to injury. In fact, the most common type of eye injury found in clinic is a corneal abrasion. Here, we utilize an ocular burr to induce an abrasion resulting in removal of the corneal epithelium in vivo on anesthetized mice. This method allows for targeted and reproducible epithelial disruption, leaving other areas intact. In addition, we describe the visualization of the abraded epithelium with fluorescein staining and provide concrete advice on how to visualize the abraded cornea. Then, we follow the timeline of wound healing 0, 18, and 72 h after abrasion, until the wound is re-epithelialized. The epithelial abrasion model of corneal injury is ideal for studies on epithelial cell proliferation, migration and re-epithelialization of the corneal layers. However, this method is not optimal to study stromal activation during wound healing, because the ocular burr does not penetrate to the stromal cell layers. This method is also suitable for clinical applications, for example, pre-clinical test of drug effectiveness.

This protocol describes a method to inflict an abrasion to the ocular surface of the mouse, and to follow the wound healing process thereafter. The protocol takes advantage of an ocular burr to partially remove the surface epithelium of the eye in anaesthetized mice.

眼毛刺角膜上皮磨损与角膜创面愈合的模型研究

The murine cornea provides an excellent model to study wound healing. The cornea is the outermost layer of the eye, and thus is the first defense to ...

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

In addition to typical reflux symptoms, many patients with gastroesophageal reflux disease (GERD) present with extraesophageal symptoms such as cough, hoarseness or asthma, which can be caused by laryngopharyngeal reflux (LPR). Due to their multifactorial origin, those symptoms can be a great diagnostic and therapeutic challenge. Esophageal pH-monitoring is commonly used to determine abnormal esophageal acid exposure and confirm the diagnosis of GERD. However, for better evaluation of acid exposure above the upper esophageal sphincter, a new laryngopharyngeal pH measurement system is now available and may lead to more reliable results in patients with predominantly extraesophageal symptoms. This article aims to present a standardized protocol for simultaneous pH measurement using esophageal and laryngopharyngeal pH probes in order to obtain acid exposure scores from both measurements.

Laryngopharyngeal pH monitoring has been specifically designed to measure acid exposure above the upper esophageal sphincter and complements diagnostic evaluation in patients that present with mainly extraesophageal reflux symptoms. Patients with suspected laryngopharyngeal reflux (LPR) were evaluated using distal esophageal and laryngopharyngeal pH testing simultaneously.

同时监测喉咽和常规食管 pH 值

In addition to typical reflux symptoms, many patients with gastroesophageal reflux disease (GERD) present with extraesophageal symptoms such as cough, ...

Three-Dimensional Collagen Matrix Scaffold Implantation as a Liver Regeneration Strategy

Liver diseases are the leading cause of death worldwide. Excessive alcohol consumption, a high-fat diet, and hepatitis C virus infection promote fibrosis, cirrhosis, and/or hepatocellular carcinoma. Liver transplantation is the clinically recommended procedure to improve and extend the life span of patients in advanced disease stages. However, only 10% of transplants are successful, with organ availability, presurgical and postsurgical procedures, and elevated costs directly correlated with that result. Extracellular matrix (ECM) scaffolds have emerged as an alternative for tissue restoration. Biocompatibility and graft acceptance are the main beneficial characteristics of those biomaterials. Although the capacity to restore the size and correct function of the liver has been evaluated in liver hepatectomy models, the use of scaffolds or some kind of support to replace the volume of the extirpated liver mass has not been assessed.
Partial hepatectomy was performed in a rat liver with the xenoimplantation of a collagen matrix scaffold (CMS) from a bovine condyle. Left liver lobe tissue was removed (approximately 40%), and an equal proportion of CMS was surgically implanted. Liver function tests were evaluated before and after the surgical procedure. After days 3, 14, and 21, the animals were euthanized, and macroscopic and histologic evaluations were performed. On days 3 and 14, adipose tissue was observed surrounding the CMS, with no clinical evidence of rejection or infection, as was vessel neoformation and CMS reabsorption at day 21. There was histologic evidence of an insignificant inflammation process and migration of adjacent cells to the CMS, observed with the hematoxylin and eosin (H&#38;E) and Masson&#39;s trichrome staining. The CMS was shown to perform well in liver tissue and could be a useful alternative for studying tissue regeneration and repair in chronic liver diseases.

Liver diseases are induced by many causes that promote fibrosis or cirrhosis. Transplantation is the only option for recovering health. However, given the scarcity of transplantable organs, alternatives must be explored. Our research proposes the implantation of collagen scaffolds in liver tissue from an animal model.

三维胶原基质支架植入作为肝脏再生策略

Liver diseases are the leading cause of death worldwide. Excessive alcohol consumption, a high-fat diet, and hepatitis C virus infection promote fibrosis, ...

Ex Vivo and In Vivo Animal Models for Mechanical and Chemical Injuries of Corneal Epithelium

Corneal injury to the ocular surface, including chemical burn and trauma, may cause severe scarring, symblepharon, corneal limbal stem cells deficiency, and result in a large, persistent corneal epithelial defect. Epithelial defect with the following corneal opacity and peripheral neovascularization result in irreversible visual impairment and hinder future management, especially keratoplasty. Since the animal model can be used as an effective drug development platform, models of corneal injury to the mouse and alkali burn to rabbit corneal epithelium are developed here. New Zealand white rabbit is used in the alkali burn model. Different concentrations of sodium hydroxide can be applied onto the central circular area of the cornea for 30 s under intramuscular and topical anesthesia. After copious isotonic normal saline irrigation, residual loose corneal epithelium was removed with corneal burr deep down to the Bowman's layer within this circular area. Wound healing was documented by fluorescein staining under Cobalt blue light. C57BL/6 mice were used in the traumatic model of murine corneal epithelium. The murine central cornea was marked using a skin punch, 2 mm in diameter, and then debrided by a corneal rust ring remover with a 0.5 mm burr under a stereomicroscope. These models can be prospectively used to validate the therapeutic effect of eye drops or mixed agents such as stem cells, which potentially facilitate corneal epithelial regeneration. By observing corneal opacity, peripheral neovascularization, and conjunctival congestion with stereomicroscope and imaging software, therapeutic effects in these animal models can be monitored.

Ex Vivo and In Vivo Animal Models for Mechanical and Chemical Injuries of Corneal Epithelium

Here, animal models based on mouse and rabbit are developed for mechanical and chemical injury of corneal epithelium to screen new therapeutics and the underlying mechanism.

角膜上皮机械和化学损伤的离体和体内动物模型

Corneal injury to the ocular surface, including chemical burn and trauma, may cause severe scarring, symblepharon, corneal limbal stem cells deficiency, ...

A Human Corneal Organ Culture Model of Descemet's Stripping Only with Accelerated Healing Stimulated by Engineered Fibroblast Growth Factor 1

Fuchs Endothelial Corneal Dystrophy (FECD) results from dysfunctional corneal endothelial cells (CECs) and is currently treated by transplantation of the whole cornea or Descemet's membrane. Recent developments in ocular surgery have established Descemet's Stripping Only (DSO), a surgical technique in which a central circle of guttae-dense Descemet's membrane is removed to allow for the migration of CECs onto the smooth stroma, restoring function and vision to the cornea. While this potential treatment option is of high interest in the field of ophthalmic research, no successful ex vivo models of DSO have been established and clinical data is limited. This work presents a novel wound-healing model simulating DSO in human donor corneas. Using this approach to evaluate the efficacy of the human engineered FGF1 (NM141), we found that treatment accelerated healing via stimulation of migration and proliferation of CECs. This finding was confirmed in 11 pairs of human corneas with signs of dystrophy reported by the eye banks in order to verify that these results can be replicated in patients with Fuchs' Dystrophy, as the target population of the DSO procedure.

Descemet's Stripping Only is an experimental procedure wherein patients with central corneal guttae resulting from Fuchs Endothelial Corneal Dystrophy have Descemet's membrane stripped for peripheral cells to regenerate the endothelial layer. We present novel methodology simulating DSO in dystrophic human corneas ex vivo with accelerated healing stimulated by eFGF1 (NM141).

一种由工程成纤维细胞生长因子1刺激的Descemet剥离的人类角膜器官培养模型，仅具有加速愈合

Fuchs Endothelial Corneal Dystrophy (FECD) results from dysfunctional corneal endothelial cells (CECs) and is currently treated by transplantation of the ...