Riboflavin use as photoprotector in laser corneal refractive surgery

Abstract

The works of different authors on the role of riboflavin in the oxidative stress suppression in tissues and organs were analyzed. Experimental and clinical studies showed that the riboflavin (vitamin B2) has antioxidant properties and acts as a coenzyme for redox enzymes affecting the glutathione reduction. Russian scientists studies established a significant negative linear correlation between the level of malondialdehyde in blood serum and riboflavin consumption. Several studies showed that riboflavin deficiency affects the activity of antioxidant enzymes, including glucose peroxidase, superoxide dismutase and catalase, which leads to a reduction in tissue cells antioxidant potential. The riboflavin feasibility in laser refractive surgery is due to the development of oxidative stress in the cornea in response to the intervention and the need for its correction. In photorefractive corneal surgery, it is worsened by secondary ablation induced by ultraviolet radiation. Works of the last few years show that the oxidative effect of the radiation is attenuated when performing the excimer laser refractive ablation after presaturation of the stroma with riboflavin solution. Experimental studies showed that both drip and aerosol corneal saturation with 0.25% isotonic riboflavin solution does not affect the accuracy of excimer laser ablation of the corneal stroma. In the clinic, performing transepithelial photorefractive keratectomy with riboflavin photoprotection for myopia with astigmatism of varying degrees and without astigmatism minimized corneal syndrome, sterile inflammatory response. It accelerated epithelialization and was accompanied by early optometric indicators stabilization, which confirmed the feasibility of riboflavin use as photoprotector in laser corneal refractive surgery.