TY - JOUR
T1 - The Antibacterial Efficacy of High-Fluence PACK Cross-Linking Can Be Accelerated
AU - Lu, Nan Ji
AU - Koliwer-Brandl, Hendrik
AU - Gilardoni, Francesca
AU - Hafezi, Nikki
AU - Knyazer, Boris
AU - Achiron, Asaf
AU - Zbinden, Reinhard
AU - Egli, Adrian
AU - Hafezi, Farhad
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Purpose: To determine whether high-fluence photoactivated chromophore for keratitis cross-linking (PACK-CXL) can be accelerated. Methods: Solutions of Staphylococcus aureus and Pseudomonas aeruginosa with 0.1% riboflavin were prepared and exposed to 365 nm ultraviolet (UV)-A irradiation of inten-sities and fluences from 9 to 30 mW/cm2 and from 5.4 to 15.0 J/cm2, respectively, repre-senting nine different accelerated PACK-CXL protocols. Irradiated solutions and unirra-diated controls were diluted, plated, and inoculated on agar plates so that the bacterial killing ratios (BKR) could be calculated. Additionally, strains of Achromobacter xylosoxi-dans, Staphylococcus epidermidis, and Stenotrophomonas maltophilia were exposed to a single accelerated PACK-CXL protocol (intensity: 30 mW/cm2, total fluence: 15.0 J/cm2 ). Results: With total fluences of 5.4, 10.0, and 15.0 J/cm2, the range of mean BKR for S. aureus was 45.78% to 50.91%, 84.13% to 88.16%, and 97.50% to 99.90%, respectively; the mean BKR for P. aeruginosa was 69.09% to 70.86%, 75.37% to 77.93%, and 82.27% to 91.44%, respectively. The mean BKR was 41.97% for A. xylosoxidans, 65.38% for S. epider-midis, and 78.04% for S. maltophilia for the accelerated PACK-CXL protocol (30 mW/cm2, 15 J/cm2). Conclusions: The BKR of high-fluence PACK-CXL protocols can be accelerated while maintaining a high, but species-dependent, BKR. The Bunsen to Roscoe law is respected in fluences up to 10 J/cm2 in S. aureus and P. aeruginosa, whereas fluences above 10 J/cm2 show strain dependence. Translational Relevance: The high-fluence PACK-CXL protocols can be accelerated in clinical practice while maintaining high levels of BKR.
AB - Purpose: To determine whether high-fluence photoactivated chromophore for keratitis cross-linking (PACK-CXL) can be accelerated. Methods: Solutions of Staphylococcus aureus and Pseudomonas aeruginosa with 0.1% riboflavin were prepared and exposed to 365 nm ultraviolet (UV)-A irradiation of inten-sities and fluences from 9 to 30 mW/cm2 and from 5.4 to 15.0 J/cm2, respectively, repre-senting nine different accelerated PACK-CXL protocols. Irradiated solutions and unirra-diated controls were diluted, plated, and inoculated on agar plates so that the bacterial killing ratios (BKR) could be calculated. Additionally, strains of Achromobacter xylosoxi-dans, Staphylococcus epidermidis, and Stenotrophomonas maltophilia were exposed to a single accelerated PACK-CXL protocol (intensity: 30 mW/cm2, total fluence: 15.0 J/cm2 ). Results: With total fluences of 5.4, 10.0, and 15.0 J/cm2, the range of mean BKR for S. aureus was 45.78% to 50.91%, 84.13% to 88.16%, and 97.50% to 99.90%, respectively; the mean BKR for P. aeruginosa was 69.09% to 70.86%, 75.37% to 77.93%, and 82.27% to 91.44%, respectively. The mean BKR was 41.97% for A. xylosoxidans, 65.38% for S. epider-midis, and 78.04% for S. maltophilia for the accelerated PACK-CXL protocol (30 mW/cm2, 15 J/cm2). Conclusions: The BKR of high-fluence PACK-CXL protocols can be accelerated while maintaining a high, but species-dependent, BKR. The Bunsen to Roscoe law is respected in fluences up to 10 J/cm2 in S. aureus and P. aeruginosa, whereas fluences above 10 J/cm2 show strain dependence. Translational Relevance: The high-fluence PACK-CXL protocols can be accelerated in clinical practice while maintaining high levels of BKR.
KW - antibacterial efficacy
KW - bacterial strain
KW - corneal cross-linking
KW - keratitis
UR - http://www.scopus.com/inward/record.url?scp=85147830230&partnerID=8YFLogxK
U2 - 10.1167/tvst.12.2.12
DO - 10.1167/tvst.12.2.12
M3 - Article
C2 - 36757342
AN - SCOPUS:85147830230
SN - 2164-2591
VL - 12
JO - Translational Vision Science and Technology
JF - Translational Vision Science and Technology
IS - 2
M1 - 12
ER -