The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking

Roy S Rubinfeld,1 Glenwood G Gum,2 Jonathan H Talamo,1,3 Edward C Parsons1 1CXL Ophthalmics, LLC, Encinitas, CA, USA; 2Absorption Systems California, LLC, San Diego, CA, USA; 3Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USACorrespondence: Roy S Rubinfe...

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Autores principales:	Rubinfeld RS, Gum GG, Talamo JH, Parsons EC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	corneal crosslinking crosslinking riboflavin iodide keratoconus ectasia Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ffae4ef9c7c34225b03944224afe1196
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spelling	oai:doaj.org-article:ffae4ef9c7c34225b03944224afe11962021-12-02T15:36:37ZThe Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking1177-5483https://doaj.org/article/ffae4ef9c7c34225b03944224afe11962021-05-01T00:00:00Zhttps://www.dovepress.com/the-effect-of-sodium-iodide-on-stromal-loading-distribution-and-degrad-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Roy S Rubinfeld,1 Glenwood G Gum,2 Jonathan H Talamo,1,3 Edward C Parsons1 1CXL Ophthalmics, LLC, Encinitas, CA, USA; 2Absorption Systems California, LLC, San Diego, CA, USA; 3Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USACorrespondence: Roy S RubinfeldCXL Ophthalmics, LLC, 3131 Connecticut Avenue NW #2809, Washington DC, 20008, USATel +1 240 305-1010Email rsrubinfeld@gmail.comPurpose: To evaluate effects of sodium iodide (NaI) on riboflavin concentration in corneal stroma before and during ultraviolet A (UVA) light exposure using a novel transepithelial corneal collagen crosslinking (CXL) procedure (EpiSmart CXL system, CXL Ophthalmics, Encinitas CA).Methods: Riboflavin solutions with NaI (Ribostat, CXL Ophthalmics, Encinitas CA) and without NaI were used for CXL in rabbits using EpiSmart. A pilot study determined sufficient riboflavin loading time. Four rabbits were dosed and monitored. Riboflavin fluorescence intensity was assessed from masked slit-lamp photos. A 12 min loading time was selected. Sixteen additional rabbits received the two formulae in contralateral eyes for CXL. Riboflavin uptake was assessed at 0, 10, 15, 20, 25, and 30 min of UVA exposure using a scale for riboflavin fluorescence previously validated against stromal concentration. Post sacrifice, corneal stromal samples were analyzed for concentrations of riboflavin and riboflavin 5ʹ-phosphate.Results: Eyes dosed with NaI riboflavin had higher riboflavin grades compared to eyes dosed with the NaI-free riboflavin formulation immediately after riboflavin loading and persisting throughout UVA exposure, with significantly higher (P < 0.01 to < 0.05) riboflavin grades from 15 through 25 min of UVA exposure. Riboflavin grades decreased more slowly in eyes dosed with NaI riboflavin through 25 minutes of UVA exposure. Minor conjunctival irritation was noted with or without NaI.Conclusion: The addition of NaI to riboflavin solution is associated with increased riboflavin concentration in corneal stroma throughout a clinically relevant time course of UVA exposure. This effect may be a combination of enhanced epithelial penetration and reduced riboflavin photodegradation and should enhance intrastromal crosslinking.Keywords: corneal crosslinking, crosslinking, riboflavin, iodide, keratoconus, ectasiaRubinfeld RSGum GGTalamo JHParsons ECDove Medical Pressarticlecorneal crosslinkingcrosslinkingriboflaviniodidekeratoconusectasiaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1985-1994 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	corneal crosslinking crosslinking riboflavin iodide keratoconus ectasia Ophthalmology RE1-994
spellingShingle	corneal crosslinking crosslinking riboflavin iodide keratoconus ectasia Ophthalmology RE1-994 Rubinfeld RS Gum GG Talamo JH Parsons EC The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
description	Roy S Rubinfeld,1 Glenwood G Gum,2 Jonathan H Talamo,1,3 Edward C Parsons1 1CXL Ophthalmics, LLC, Encinitas, CA, USA; 2Absorption Systems California, LLC, San Diego, CA, USA; 3Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USACorrespondence: Roy S RubinfeldCXL Ophthalmics, LLC, 3131 Connecticut Avenue NW #2809, Washington DC, 20008, USATel +1 240 305-1010Email rsrubinfeld@gmail.comPurpose: To evaluate effects of sodium iodide (NaI) on riboflavin concentration in corneal stroma before and during ultraviolet A (UVA) light exposure using a novel transepithelial corneal collagen crosslinking (CXL) procedure (EpiSmart CXL system, CXL Ophthalmics, Encinitas CA).Methods: Riboflavin solutions with NaI (Ribostat, CXL Ophthalmics, Encinitas CA) and without NaI were used for CXL in rabbits using EpiSmart. A pilot study determined sufficient riboflavin loading time. Four rabbits were dosed and monitored. Riboflavin fluorescence intensity was assessed from masked slit-lamp photos. A 12 min loading time was selected. Sixteen additional rabbits received the two formulae in contralateral eyes for CXL. Riboflavin uptake was assessed at 0, 10, 15, 20, 25, and 30 min of UVA exposure using a scale for riboflavin fluorescence previously validated against stromal concentration. Post sacrifice, corneal stromal samples were analyzed for concentrations of riboflavin and riboflavin 5ʹ-phosphate.Results: Eyes dosed with NaI riboflavin had higher riboflavin grades compared to eyes dosed with the NaI-free riboflavin formulation immediately after riboflavin loading and persisting throughout UVA exposure, with significantly higher (P < 0.01 to < 0.05) riboflavin grades from 15 through 25 min of UVA exposure. Riboflavin grades decreased more slowly in eyes dosed with NaI riboflavin through 25 minutes of UVA exposure. Minor conjunctival irritation was noted with or without NaI.Conclusion: The addition of NaI to riboflavin solution is associated with increased riboflavin concentration in corneal stroma throughout a clinically relevant time course of UVA exposure. This effect may be a combination of enhanced epithelial penetration and reduced riboflavin photodegradation and should enhance intrastromal crosslinking.Keywords: corneal crosslinking, crosslinking, riboflavin, iodide, keratoconus, ectasia
format	article
author	Rubinfeld RS Gum GG Talamo JH Parsons EC
author_facet	Rubinfeld RS Gum GG Talamo JH Parsons EC
author_sort	Rubinfeld RS
title	The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
title_short	The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
title_full	The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
title_fullStr	The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
title_full_unstemmed	The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking
title_sort	effect of sodium iodide on stromal loading, distribution and degradation of riboflavin in a rabbit model of transepithelial corneal crosslinking
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/ffae4ef9c7c34225b03944224afe1196
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The Effect of Sodium Iodide on Stromal Loading, Distribution and Degradation of Riboflavin in a Rabbit Model of Transepithelial Corneal Crosslinking

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