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中华眼科医学杂志(电子版) ›› 2022, Vol. 12 ›› Issue (03) : 188 -192. doi: 10.3877/cma.j.issn.2095-2007.2022.03.012

综述

促渗剂在去上皮角膜胶原交联术和跨上皮角膜胶原交联术中应用的研究进展
张艺凡1, 戴锦晖2,†(), 叶琳3   
  1. 1. 200031　复旦大学附属眼耳鼻喉科医院2020级博士研究生
    2. 200032　复旦大学附属中山医院眼科　国家卫生健康委员会近视眼重点实验室
    3. 200032　复旦大学附属中山医院2021级博士研究生
  • 收稿日期:2021-08-02 出版日期:2022-06-28
  • 通信作者: 戴锦晖
  • 基金资助:
    国家自然科学基金面上项目(81970831)

Advance on the penetration enhancers of standard corneal collagen crosslinking and trans-epithelial corneal collagen crosslinking

Yifan Zhang1, Jinhui Dai2,†(), Lin Ye3   

  1. 1. Doctor′s degree 2020, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
    2. Department of Ophthalmology, Zhongshan Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University), Shanghai 200032, China
    3. Doctor′s degree 2021, Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Received:2021-08-02 Published:2022-06-28
  • Corresponding author: Jinhui Dai
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张艺凡, 戴锦晖, 叶琳. 促渗剂在去上皮角膜胶原交联术和跨上皮角膜胶原交联术中应用的研究进展[J]. 中华眼科医学杂志(电子版), 2022, 12(03): 188-192.

Yifan Zhang, Jinhui Dai, Lin Ye. Advance on the penetration enhancers of standard corneal collagen crosslinking and trans-epithelial corneal collagen crosslinking[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2022, 12(03): 188-192.

角膜胶原交联(CXL)是利用光敏剂的光化学反应增加角膜胶原纤维间和内部化学键对酶解的抵抗力，增强角膜的生物力学强度，减缓圆锥角膜和角膜扩张等病变进展的一种技术。目前，CXL主要使用紫外线(或)黄素单核苷酸交联。经典的角膜胶原交联手术(S－CXL)是通过去除角膜上皮以辅助光敏剂药物渗透至角膜基质，该方法对患者的不适感强且术后并发症多。在S－CXL基础上，向光敏剂药物中添加促渗剂，即为跨上皮角膜胶原交联术(TE－CXL)。TE－CXL则具有舒适度佳、安全性高且应用范围广等优点。本文中笔者就TE－CXL促渗剂种类、特点及作用机制的研究进展进行综述，以期为促渗剂的选择和TE－CXL递药系统设计提供新思路。

关键词: 圆锥角膜, 角膜胶原交联, 促渗剂, 跨上皮交联手术

Corneal collagen crosslinking (CXL) is a newly evolved technique that can increase the chemical bonds between and within corneal collagen fibers and tissue resistance to enzymatic dissolution based on Laws of photochemistry for photosensitizer, thereby enhancing the biomechanical strength of the cornea and slowing the progression of lesions such as keratoconus and keratectasia. Currently, the ultraviolet A and (or) riboflavin crosslinking has been widely used to complete CXL. The standard CXL (S-CXL) method is the penetration of assisted photosensitizer to corneal stroma by removing corneal epithelium, which has postoperative complications and is discomfort for patients. Based on CXL, the penetration enhancers are added into photosensitizers, which is trans-epithelial CXL (TE-CXL). It has a wider range of application coverage, and is safer and more comfortable. The type of penetration enhancers of TE-CXL, characteristics and mechanism of action were reviewed, aiming to provide a new idea for selection of penetration enhancers and design of delivery system.

Key words: Keratoconus, Corneal crosslinking, Penetration enhancer, Trans-epithelial-corneal collagen crosslinking
表1 跨上皮角膜胶原交联的商用制剂
商品名 制剂组成 制造商
Paracel 0.25%质量浓度黄素单核苷酸、羟丙甲纤维素、乙二胺四乙酸钠、氨基丁三醇、乙二胺四乙酸及苯扎氯铵 德国Medio Haus公司
Medio CROSS 0.22%质量浓度黄素单核苷酸、羟丙甲纤维素及0.01%苯扎氯铵 德国Medio Haus公司
Ribocross 0.122%质量浓度黄素单核苷酸、高分子右旋糖酐及维生素E聚乙二醇琥珀酸酯 意大利IROS公司
Ricrolin 0.1%质量浓度黄素单核苷酸、高分子右旋糖酐及乙二胺四乙酸 意大利Sooftitalia公司
Peschke 0.25%质量浓度黄素单核苷酸、羟丙甲纤维素及0.01%苯扎氯铵 瑞士Peschke Trade公司
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