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Modified riboflavin formula could enable transepithelial cross-linking
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 François Malecaze |
PARIS — The future of cross-linking will be transepithelial delivery, but modifications of the current riboflavin formula have not reached the appropriate standard, according to a speaker here.
Riboflavin, or vitamin B2, micromolecules cannot pass through the tight corneal epithelial junctions. Several laboratories are attempting to modify the pharmacokinetics of riboflavin to enhance penetration, and one product, Ricrolin TE (Sooft Italia), is currently available in Europe.
"We have been studying the intracorneal penetration of Ricrolin TE. We first performed animal studies, using biochemical and immunohistochemical methods. Then we performed a clinical study on 20 patients, treating one eye with conventional Ricrolin and one eye with Ricrolin TE, using fluorophotometry analysis," François Malecaze, MD, said at the meeting of the French Society of Ophthalmology.
All studies confirmed that Ricrolin TE penetrates the epithelium and diffuses into the stroma. However, the saturation of the stroma by the photosensitizing agent is not yet comparable to that obtained by conventional riboflavin after removal of the epithelium.
"The main question now is whether this amount of transepithelial diffusion is sufficient to induce cross-linking. We don't have an answer yet," Dr. Malecaze said.
- Disclosure: Dr. Malecaze has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.