Bactericidal Efficacy of High Irradiance Ultraviolet A Photoactivation of Riboflavin Versus Standard Corneal Cross-Linking Protocol In Vitro

Cornea. 2022 Sep 1;41(9):1166-1170. doi: 10.1097/ICO.0000000000003031. Epub 2022 Mar 30.

Abstract

Purpose: The purpose of this study was to compare the efficacy of high ultraviolet A (UVA) irradiance photoactivation of riboflavin (vitamin B2) versus the standard corneal cross-linking protocol on bacterial viability.

Methods: Methicillin-sensitive Staphylococcus aureus (MSSA) Newman strain and methicillin-resistant multidrug-resistant S. aureus (MDR-MRSA) USA300, CA409, CA127, GA656, and NY315 strains were exposed to a UVA energy dose of 5.4 to 6 J/cm 2 by 2 high irradiance regimens: A) 30 mW/cm 2 for 3 minutes and B) 10 mW/cm 2 for 10 minutes with B2 0.1%. Control groups included B2/UVA alone, CA409 exposed to standard B2 0.1% + UVA (3 mW/cm 2 for 30 minutes), and an untreated sample. Cell viability was assessed. Triplicate values were obtained. The Mann-Whitney test and Student t test were used for statistical analysis.

Results: There was no difference comparing the median bacterial load (log CFU/mL) of the untreated samples versus regimen A: Newman P = 0.7, CA409 P = 0.3, USA300 P = 0.5, CA127 P = 0.6, GA656 P = 0.1, and NY315 P = 0.2 ( P ≥ 0.1); and B: Newman P = 0.1, CA409 P = 0.3, USA300 P = 0.4, CA127 P = 0.6, GA656 P = 0.1, and NY315 P = 0.3 ( P ≥ 0.1). Standard regimen killed 100% of CA409.

Conclusions: Photoactivation of B2 by high UVA irradiance does not seem to be effective for bacterial eradication in this study.

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Cornea / physiology
  • Cross-Linking Reagents / pharmacology
  • Methicillin-Resistant Staphylococcus aureus* / drug effects
  • Methicillin-Resistant Staphylococcus aureus* / radiation effects
  • Photosensitizing Agents* / pharmacology
  • Riboflavin* / pharmacology
  • Ultraviolet Rays
  • Ultraviolet Therapy

Substances

  • Anti-Bacterial Agents
  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Riboflavin