CXL, Corneal Cross-linking

CXL,角膜交联
  • 文章类型: Journal Article
    角膜移植术是临床治疗角膜疾病的有效方法,which,然而,受到供体角膜的限制。开发具有“透明”和“上皮和基质生成”功能的生物粘附性角膜补片具有重要的临床价值,以及“无情”和“坚韧”。同时满足\"T.E.S.T.“要求,基于甲基丙烯酰化明胶(GelMA)设计了一种光固化水凝胶,PluronicF127二丙烯酸酯(F127DA)和醛化PluronicF127(AF127)共组装双功能胶束和I型胶原蛋白(COLI),结合临床应用的角膜交联(CXL)技术修复受损角膜。紫外线照射5分钟后形成的贴片具有透明,非常艰难,和强大的生物粘合性能。多次交联使贴片承受近600%的变形,并表现出大于400mmHg的爆裂压力,显著高于正常眼压(10-21mmHg)。此外,与无COLI的GelMA-F127DA和AF127水凝胶相比,降解速度较慢,使水凝胶贴片在体内基质床上稳定,支持角膜上皮和基质的再生。水凝胶贴剂可在4周内替代角膜深层基质缺损,并能很好地生物整合到兔模型的角膜组织中,联合CXL在圆锥角膜和其他角膜疾病的手术中显示出巨大的潜力。
    Corneal transplantation is an effective clinical treatment for corneal diseases, which, however, is limited by donor corneas. It is of great clinical value to develop bioadhesive corneal patches with functions of \"Transparency\" and \"Epithelium & Stroma generation\", as well as \"Suturelessness\" and \"Toughness\". To simultaneously meet the \"T.E.S.T.\" requirements, a light-curable hydrogel is designed based on methacryloylated gelatin (GelMA), Pluronic F127 diacrylate (F127DA) & Aldehyded Pluronic F127 (AF127) co-assembled bi-functional micelles and collagen type I (COL I), combined with clinically applied corneal cross-linking (CXL) technology for repairing damaged cornea. The patch formed after 5 min of ultraviolet irradiation possesses transparent, highly tough, and strongly bio-adhesive performance. Multiple cross-linking makes the patch withstand deformation near 600% and exhibit a burst pressure larger than 400 mmHg, significantly higher than normal intraocular pressure (10-21 mmHg). Besides, the slower degradation than GelMA-F127DA&AF127 hydrogel without COL I makes hydrogel patch stable on stromal beds in vivo, supporting the regrowth of corneal epithelium and stroma. The hydrogel patch can replace deep corneal stromal defects and well bio-integrate into the corneal tissue in rabbit models within 4 weeks, showing great potential in surgeries for keratoconus and other corneal diseases by combining with CXL.
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  • 文章类型: Case Reports
    未经授权:报告由紫草引起的微生物性角膜炎的首例病例,真菌性角膜炎的罕见原因。
    UNASSIGNED:一位66岁的绅士,拥有复杂的右眼(OD)眼部病史,包括单纯疱疹病毒感染性上皮性角膜炎并随后发生神经营养性角膜病变,和先前合并的白色念珠菌和近apsilioma真菌性角膜炎在没有先前创伤的情况下表现为疼痛OD。病人被发现有丝状真菌性角膜炎,随后被实验室培养并鉴定为Phialophorachinensis。尽管根据实验室确定的敏感性进行了局部和口服抗真菌治疗,患者最终需要在基质内和结膜下注射抗真菌药物,角膜交联,和浅表角膜切除术与羊膜的临床改善。真菌性角膜炎复发两次,每次发生迅速进展为角膜穿孔。第二次穿透性角膜移植术后的几个月,患者的精神状态因多器官功能衰竭而下降。在住院期间发现了隐匿性肺部恶性肿瘤,患者在进入临终关怀医院后失去了随访。
    UNASSIGNED:我们报告了一例由中华phialophora引起的真菌性角膜炎的独特病例以及随后的治疗方法,包括医疗和手术干预。尽管采用了多模式治疗方案,该病例显示了由中国黄曲霉引起的真菌性角膜炎的顽固性和潜在复发性。
    UNASSIGNED: To report the initial case of microbial keratitis caused by Phialophora chinensis, a rare cause of fungal keratitis.
    UNASSIGNED: A 66-year-old gentleman with a complex right eye (OD) ocular history including herpes simplex virus infectious epithelial keratitis with subsequent neurotrophic keratopathy, and prior combined Candida albicans and parapsilosis fungal keratitis presented with pain OD in the absence of an antecedent trauma. The patient was found to have a filamentous fungal keratitis, which was subsequently cultured and identified as Phialophora chinensis by the laboratory. Despite topical and oral antifungal treatment based on sensitivities determined by the lab, the patient ultimately required intrastromal and subconjunctival antifungal injections, corneal crosslinking, and superficial keratectomy with amniotic membrane to clinically improve. The fungal keratitis recurred twice, with each occurrence rapidly progressing to corneal perforation. Months after the second penetrating keratoplasty, the patient\'s mental status declined due to multiorgan failure. An occult pulmonary malignancy was discovered during this hospital stay, and the patient was lost to follow-up after entering hospice.
    UNASSIGNED: We report a unique case of fungal keratitis caused by Phialophora chinensis and the subsequent management, including both medical and surgical interventions. Despite a multimodal treatment regimen, this case demonstrates the recalcitrant and potentially recurrent nature of fungal keratitis caused by P. chinensis.
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