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Fluorescein competes riboflavin in corneal collagen cross-linking (CXL) for the treatment of infectious keratitis

Session Details

Session Title: Cross-linking

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 15:08

Venue: Elicium 2 (First Floor)

First Author: : F.Hoogewoud SWITZERLAND

Co Author(s): :    O. Richoz   Z. Gkatzioufas   A. Hammer   F. Hafezi     

Abstract Details


To evaluate the competition of fluorescein with riboflavin during the treatment of infectious keratitis with CXL.


Bacterial keratitis represents a leading cause of global blindness. Recently, the antimicrobial properties of CXL against common pathogens have been demonstrated in vitro and CXL has been successfully used in the treatment of refractory infectious keratitis. Here we provide evidence that fluorescein competes riboflavin in UV-A absorption during CXL.


We analyzed the UVA-absorption of riboflavin and fluorescein by spectrophotometry at various concentrations. Staphylococcus aureus strains were used in all experiments. The number of colony-forming units was counted after a 24 h incubation period and the killing rate (antimicrobial efficacy) was determined.


The antimicrobial efficacy in the irradiated bacterial solution was at a killing rate of 82% when irradiation was performed using 0.1 riboflavin solution. When 1% fluorescein was added, the killing rate dropped to 19%.


Fluorescein absorbs UV-A in a significant and concentration-depending manner and the addition of fluorescein leads to a significant reduction in the antimicrobial efficacy of CXL. In consequence, preoperative staining of an ulcus or infiltrate should be avoided.

Financial Interest:


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