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Evaluation of UV radiation on human cornea in ophthalmic procedures

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Author(s):
Victor Antonio Cacciacarro Lincoln
Total Authors: 1
Document type: Doctoral Thesis
Press: São Carlos.
Institution: Universidade de São Paulo (USP). Escola de Engenharia de São Carlos (EESC/SBD)
Defense date:
Examining board members:
Liliane Ventura; Leonardo Vidal Batista; Adilson Gonzaga; Cristina Kurachi; Luís Antonio Gorla Marcomini
Advisor: Liliane Ventura
Abstract

Ultraviolet radiation can either be a benefit as an harm to the human eye. The benefits are when used in ophthalmic procedures for vision correction, as in the photorefractive surgery - UVC - 193 nm; or to, among other treatments, preventing the progression of diseases, such as the corneal collagen crosslinking, for keratoconus in the early stages - that uses UVA - 370 nm. The harm effects are already widely known by the scientific community and general population, about excessive incidence of UV radiation in the eye, that can cause severe damage to the human eye. However, the cornea has a natural UVA and UVB protection. In this work, we studied the two ophthalmic procedures cited in order to investigate possible damage to the human eye, as the loss of cornea UV natural protection after photorefractive surgery, which removes corneal lamella; and the amount of radiation that penetrates the human eye during the corneal collagen crosslinking, that uses Riboflavin as a synthesizer and UVA radiation blocking. A portable system was developed to evaluate the UV protection and the UV damage for the first case. The prototype consists of a double beam system that analyzes the corneal tissue transmittance in the 300-400 nm range, and presents a correlation factor r2>0.98. Measurements with tissue removal showed the importance of each corneal layer, specially the stroma removal that shows a significant loss of natural UV protection, with an increase of 8.2 to 10.1 percentage points. As for the crosslinking, using riboflavin and UVA irradiance combination, with 3 mw/\'CM POT.2\' for 30 minutes, was performed a monitoring of UVA transmittance during treatment. Current procedure protocol was performed, i.e., one drop of riboflavin 0.1%, 400mOsm, was applied on the naked cornea, every 5 minutes (total of 12 drops). The UV irradiation (365 ± 5 nm, 3 mW/\'CM POT.2\') was performed after 30 min of instillation for an additional 30 min. The average transmittance of the desepithelized cornea without Riboflavin is 61.6%; after the 1st drop of Riboflavin, transmittance is 44.9%; after 6th drop 22.4%; after 7th drop (irradiation starts), 19.5%; after 8th drop; 17.3%; after 9th drop, 15.8%; after 10h drop, 14.5%; after 11th drop, 13.6%; after 12th drop, 12.6%. The average transmittance in terms of energy during the 30 min irradiation procedure fluctuated from 0.590 to 0.380 mW/\'CM POT.2\', beyond the currently accepted rabbit corneal endothelium safety limit for cytotoxic level of 0.360 mW/\'CM POT.2\'. (AU)

FAPESP's process: 10/06299-0 - Measurements performed in vitro corneas for evaluation of ophthalmological procedures
Grantee:Victor Antonio Cacciacarro Lincoln
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)