Journal of Clinical Medicine
Enhanced Effects of Riboflavin/UVA Crosslinking, N-Acetylcysteine, and Polydatin on Collagenase Resistance in Human Corneal and Scleral Tissue: A Pilot Ex Vivo Study
By Cosimo Giuseppe Mazzotta, F. Cappellani, Mayank Ambarish Nanavaty and 4 others.
Abstract
Purpose
To investigate whether N-acetylcysteine (NAC) and Polygonum cuspidatum extract enhance riboflavin/ultraviolet-A crosslinking (CXL), exploring a potential adjunctive strategy for corneal and scleral tissue stabilization.
Methods
In this pilot ex vivo study, 12 human corneal buttons and 12 scleral strips were assigned to six groups: untreated controls, CXL alone, adjunctive treatment alone, and adjunctive treatment before, after, or both before and after CXL. Accelerated CXL was performed at 9 mW/cm2 for 10 min (5.4 J/cm2). Resistance to collagenase-mediated degradation and corneal protein release were evaluated.
Results
CXL increased corneal degradation time from 7 ± 2 to 14 ± 2 days and scleral degradation time from 10 ± 2 to 19 ± 3 days. Combined pre- and post-CXL adjunctive treatment further prolonged resistance to 21 ± 2 days in corneas (p < 0.001) and 27 ± 3 days in sclerae (p < 0.01), compared with CXL alone. Corneal protein release decreased by 84% and 52% at days 5 and 10, respectively (both p < 0.01).