Corneal Tissue Research Articles

Collagen crosslinking-induced corneal morphological changes: a three-dimensional light sheet Microscopy-based evaluation.

Stiffness-related eye diseases such as keratoconus require comprehensive visualization of the complex morphological matrix changes. The aim of this study was to use three-dimensional (3D) light sheet fluorescence microscopy (LSFM) to analyze unlabeled corneal tissue samples, qualitatively visualizing changes in corneal stiffness. Isolated porcine corneal tissue samples were treated with either NaCl or 0.1% glutaraldehyde (GTA) prior to clearing with benzyl alcohol/benzyl benzoate (BABB) and subsequently scanned with LSFM. After analysis of the LSFM data sets, the samples were embedded in paraffin to validate the results by conventional planar microscopy. In the unlabeled corneal tissue samples the 2D/3D morphology of the entire tissue volume was identified by specific autofluorescence signals. An enhancement of collagen crosslinking was induced by applying GTA to the corneal tissue. Subsequent LSFM scans showed specific morphological changes due to altered autofluorescence signals of the corneal stroma, which were confirmed by conventional histology. Therefore, LSFM analysis of corneal tissue samples allowed label-free 3D autofluorescence assessment of the corneal morphology in its anatomical context. It provides the technical basis for the examination of the pathologically altered cornea and facilitates ophthalmologic examinations of corneal diseases based on the altered tissue stiffness.

Advanced bioengineering strategies broaden the therapeutic landscape for corneal failure

The cornea acts as the eye foremost protective layer and is essential for its focusing power. Corneal blindness may arise from physical trauma or conditions like dystrophies, keratitis, keratoconus, or ulceration. While conventional treatments involve medical therapies and donor allografts—sometimes supplemented with keratoprostheses—these options are not suitable for all corneal defects. Consequently, the development of bioartificial corneal tissue has emerged as a critical research area, aiming to address the global shortage of human cornea donors. Bioengineered corneas hold considerable promise as substitutes, with the potential to replace either specific layers or the entire thickness of damaged corneas. This review first delves into the structural anatomy of the human cornea, identifying key attributes necessary for successful corneal tissue bioengineering. It then examines various corneal pathologies, current treatments, and their limitations. Finally, the review outlines the primary approaches in corneal tissue engineering, exploring cell-free, cell-based, and scaffold-based options as three emerging strategies to address corneal failure.

In vivo assessment of topically applied silver nanoparticles on entire cornea: comprehensive FTIR study

Silver nanoparticles (AgNPs) have gained attention in medicine for their potent antibacterial, antiviral, and anti-inflammatory properties. The use of silver nanoparticles in ophthalmic solutions raises concerns regarding potential toxicity of nanoparticles to ocular tissues, such as the cornea, conjunctiva, and retina, which necessitates further toxicity assessments aiding in the development of safer ophthalmic solutions. This study investigates the impact of AgNPs on corneal tissue using ophthalmic investigations, Fourier transform infrared (FTIR) spectroscopy, and chemometric analyses. Three concentrations of AgNPs (0.48 µg/mL, 7.2 µg/mL, and 15.5 µg/mL) were topically applied twice daily for 10 days, synthesized biologically by reducing silver nitrate with almond kernels water extract. Corneas, obtained by cutting 2–3 mm below the ora serrata, were analyzed with FTIR spectroscopy and subjected to chemometric analyses. Results reveal AgNPs’ influence on constituents with OH and NH groups, affecting corneal lipids and reducing the lipid saturation index. AgNPs alter both bulk and interfacial water, leading to changes in corneal hydration thus modifying corneal physico-chemical properties. The influence extends to the water environment around proteins and lipids, releasing bound water from phospholipids and disrupting hydrogen bonding networks around proteins. In conclusion, the applied AgNPs concentrations can be linked to dry eye onset.

Determining the Relationship Between Corneal Stiffening and Tissue Dehydration After Corneal Cross-Linking.

To quantify corneal cross-linking (CXL)-induced stiffening via mechanical testing to estimate the impact of changes in hydration levels (H) and evaluate depth-dependent tissue hydration after CXL. Eighty-three porcine corneal buttons were divided into three groups: Standard protocol CXL (S-CXL), accelerated CXL (A-CXL), and untreated (nonirradiated riboflavin-only) controls. Samples were hydrated or dehydrated to modulate H and dynamic mechanical analyzer compression tests were performed to measure Young's modulus (E). To extract the solid tissue network modulus, the cornea was modeled as a biphasic material after measuring E at different H. Corneal hydration was correlated with depth-dependent tissue thickness characterized by confocal reflection microscopy (CRM). Young's modulus increased fourfold after S-CXL (0.72 ± 0.1 MPa) and threefold after A-CXL E (0.53 ± 0.12 MPa) versus controls (0.17 ± 0.045 MPa). However, H decreased from 4.07 ± 0.35 in controls to 2.06 ± 0.2 after S-CXL and 2.79 ± 0.12 after A-CXL. After H modulation and biphasic mechanical modeling, Young's modulus for corneal solid tissue network showed only a 1.8-fold increase after S-CXL (2.25 MPa) and 1.5-fold increase after A-CXL (1.85 MPa) versus controls (1.22 MPa). With CRM, the overall thickness of the corneal tissue was found to linearly correlate to hydration H as expected. No appreciable depth dependence of hydration-induced thickness changes throughout the corneal buttons were observed. Corneal tissue hydration changes significantly impact measured corneal stiffness after CXL using mechanical testing. Not considering H leads to major overestimation of the stiffening effect of the CXL procedure. Depth-dependence of corneal thickness because of changing hydration is strongly dependent on the integrity of the tissue.

Characterization of Disrupted Tissue Interface Thickness for Keratorefractive Lenticule Extraction Procedure With ELITA Femtosecond Laser.

This study identified and compared variables causing changes in corneal tissue structure following the smooth incision lenticular keratomileusis (SILK) procedure using the ELITA Femtosecond Laser System by characterizing the resulting disrupted tissue interface. Seventy-one ex vivo porcine eyes and six human cadaver eyes underwent ELITA SILK with diverse surgical steps, pulse energies, scan overlaps, and surgical methods. Flaps created with the iFS Advanced Femtosecond Laser and ELITA systems were also evaluated. The disrupted interface thickness was determined by imaging corneal layers at different depths through the interface with confocal microscopy and counting layers with elevated backscattered light via computer program-assisted, subject-matter-expert visual judgment with blinding. The disrupted interface thickness for ELITA SILK was 25 ± 3 µm; for the ELITA flap, it was 25 ± 2 µm; and for the iFS flap, it was 32 ± 3 µm. Factors influencing the total ELITA SILK disrupted interface thickness included laser pulse energy (0.11µm/nJ; P < 0.01), scan overlap (5µm; P < 0.01), and mechanical manipulation (7µm; P < 0.01). Varying surgical techniques for mechanical manipulation resulted in a difference in disrupted interface thickness of 4µm (P < 0.01). The ELITA SILK disrupted interface thickness was less than that of the iFS flap and similar to that of the ELITA flap. Assessing disrupted interface thickness identified factors influencing the quality of the corneal interface with SILK. The disrupted interface thickness, a new method for measuring corneal damage, has been used to quantify the potential effects of various refractive surgery factors on surgical outcomes.

Restoration of Corneal Stiffness in Rabbits Following Withdrawal of Travoprost.

To evaluate if the effect of travoprost on corneal material stiffness could be restored after drug withdrawal. Seventy-two rabbits were randomly allocated into three groups: medicine (M), medicine withdrawal (MW), and blank (B). Within the M and MW groups, treatment with travoprost was administered to the right eyes (MT and MWT) over a period of 12 weeks. Subsequently, the M group was killed, but the MW group underwent an additional 12-week period for treatment withdrawal. No treatment was given to the contralateral eyes (MC and MWC) in the M and MW groups. A separate blank control (BC) group remained untreated for the entire 24-week duration. In each group, corneas from 18 rabbits were tested mechanically under inflation conditions to estimate their tangent modulus (Et). The corneas of the remaining six rabbits underwent electron microscopy analysis, which focused on fibril diameter and interfibrillar spacing. Central corneal thickness (CCT) of the treated eyes (MT and MWT groups) decreased with 12 weeks of travoprost treatment (P < 0.05). The CCT in the MWT group increased after 12 weeks of withdrawal but was still lower than that in the BC group (P < 0.05). The Et of the MT group was significantly lower than that of the MC group at mean tissue stresses of 2, 4, and 6 kPa (P < 0.05). Conversely, no significant difference in Et values was observed between the MWT, MWC, and BC groups, indicating recovery after treatment cessation. Furthermore, the stromal interfibrillar spacing of the treated MT group was significantly larger (P < 0.05) than that of the control MC group, but no disparity was noted among the MWT, MWC, and BC groups following treatment withdrawal. Additionally, there were no significant differences in the mean diameter of collagen fibrils among all groups (all P > 0.05). Travoprost treatment appears to soften corneal tissue, decrease tissue thickness, and reduce the density of stromal collagen fibers by increasing the interfibrillar spacing. These changes were partially reversed after treatment cessation. Travoprost could further inhibit corneal growth, so its use in childhood and adolescence should be carefully considered. Additionally, the effect of travoprost in reducing corneal stiffness may lead to underestimations of intraocular pressure (IOP) measurement and hence overestimations in the effect of treatment in lowering IOP.

Far-Ultraviolet C Disinfection Reduces Oxidative Damage to the Cornea Compared to Povidone-Iodine Disinfection

Far-ultraviolet C (far-UVC) light shows promise for pathogen control but its safety and efficacy for corneal disinfection remain unclear. In this study, safe far-UVC dosages were investigated for corneal disinfection and its germicidal performance and oxidative damage potential to 5% povidone-iodine (PVP-I) were compared. Rat corneas were exposed to varying 222 nm far-UVC doses (3–60 mJ/cm2) and assessed for ocular damage, apoptosis, and oxidative stress to determine the safe dose of far-UVC. Far-UVC at 30 mJ/cm2 induced corneal apoptosis and oxidative damage, but 15 mJ/cm2 caused no apoptosis or oxidative damage. At this optimized dose (9 mJ/cm2), far-UVC achieved 90.5% sterilization, exceeding 5% PVP-I (80.8%), with significantly less oxidative damage and cell death in the cornea. In conclusion, our study demonstrates that the use of 5% povidone-iodine (PVP-I) for disinfection results in significant oxidative damage to the corneal tissue. However, a safe dosage of far-UVC light exhibited a promising disinfection effect without causing oxidative damage to the corneal tissue. Far-UVC offers a promising alternative for corneal disinfection but requires careful dosage control (≤30 mJ/cm2) to avoid ocular surface harm.

Ray-tracing-Guided or Q-Value-Adjusted FS-LASIK for Correction of Myopia and Myopic Astigmatism: A Comparative Contralateral Eye Study.

To compare the safety and efficacy of individualized ray-tracing-guided femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of myopia and myopic astigmatism. This prospective, randomized, double-blind, contralateral eye study included 68 eyes of 34 patients with myopia or myopic astigmatism requiring FS-LASIK treatment. For each patient, one eye was randomly assigned to receive the ray-tracing-guided treatment, whereas the contralateral eye underwent Q-value-adjusted ablation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), sphere, cylinder, effective optical zone (EOZ), and 6-mm corneal aberrations were measured and analyzed before operation and after a 3-month postoperative follow-up. At 3 months postoperatively, the UDVA of 20/16 or better was measured in 94% of eyes in the ray-tracing group and 85% of eyes in the Custom-Q group (P = .064). Forty-seven percent in the ray-tracing group and 32% in the Custom-Q group gained one or more Snellen lines of CDVA (P = .043). The MRSE, refractive astigmatism, surgically induced astigmatism, and difference vector were better in the Custom-Q group (P < .05). The postoperative corneal HOAs and optical path difference were significantly better in the ray-tracing group (P = .008). The EOZs of the ray-tracing and Custom-Q groups were 5.77 and 5.43 mm (P < .001), and the average ablation depths of the ray-tracing and Custom-Q groups were 100.97 and 85.24 µm (P < .001), respectively. Despite the overcorrection and excessive ablation of corneal tissue, ray-tracing-guided FS-LASIK in clinical practice was found to be safe and effective for myopic correction both with and without astigmatism, particularly in achieving UDVA and inducing fewer corneal HOAs and less OPD. [J Refract Surg. 2024;40(11):e804-e813.].

Advancements in Hydrogels for Corneal Healing and Tissue Engineering.

Hydrogels have garnered significant attention for their versatile applications across various fields, including biomedical engineering. This review delves into the fundamentals of hydrogels, exploring their definition, properties, and classification. Hydrogels, as three-dimensional networks of crosslinked polymers, possess tunable properties such as biocompatibility, mechanical strength, and hydrophilicity, making them ideal for medical applications. Uniquely, this article offers original insights into the application of hydrogels specifically for corneal tissue engineering, bridging a gap in current research. The review further examines the anatomical and functional complexities of the cornea, highlighting the challenges associated with corneal pathologies and the current reliance on donor corneas for transplantation. Considering the global shortage of donor corneas, this review discusses the potential of hydrogel-based materials in corneal tissue engineering. Emphasis is placed on the synthesis processes, including physical and chemical crosslinking, and the integration of bioactive molecules. Stimuli-responsive hydrogels, which react to environmental triggers, are identified as promising tools for drug delivery and tissue repair. Additionally, clinical applications of hydrogels in corneal pathologies are explored, showcasing their efficacy in various trials. Finally, the review addresses the challenges of regulatory approval and the need for further research to fully realize the potential of hydrogels in corneal tissue engineering, offering a promising outlook for future developments in this field.

Outcomes of sclerokeratoplasty in severe ocular surface disease

Sclerocorneal grafts are procedures considered in cases with extensive corneal and scleral tissue destruction. The study aims to describe sclerokeratoplasty outcomes in severely diseased eyes. We performed a retrospective review of clinical records. Demographic characteristics, medical history, surgical indications, aetiology of perforation, visual outcomes, complications associated with the surgical procedure, and ocular integrity at the end of the follow-up were obtained. Wilcoxon-signed rank tests and Mann-Whitney tests were used to compare complications between groups and outcomes at final follow-up. Survival analysis was performed to analyse vision preservation and global integrity and presented in Kaplan-Meier curves. 40 eyes from 40 patients with a mean age of 48.83 ± 18.85 years and a mean follow-up of 21.13 ± 33.92 months were included in the study. Median corrected visual acuity before and after the procedure remained at 2.8 logMAR. Twenty-seven eyes presented complications. The most common complications were a persistent epithelial defect in 11, hypertension in 10, and perforation in 8 eyes. More than half of the eyes (67.5%) presented with either one or more of all complications after corneoscleral graft. No significant differences were found regarding age, gender, or DM history. Concerning perforation, a significant difference was found between infectious and non-infectious only in the presentation of ocular hypertension (p = 0.048). Vision was preserved in 72.5% of the eyes, with a median survival probability of 4.12 years. Preservation of the ocular integrity was achieved in 85% of the eyes, with a median survival probability of 12 years. Sclerokeratoplasty despite being challenging and technically demanding followed by defiant complications, in some situations such as infectious keratitis and autoimmune diseases, is likely a procedure that salvages the eye and preserves vision.

Advancements in Polymer Biomaterials as Scaffolds for Corneal Endothelium Tissue Engineering

Corneal endothelial dysfunction is a leading cause of vision loss globally, frequently requiring corneal transplantation. However, the limited availability of donor tissues, particularly in developing countries, has spurred on the exploration of tissue engineering strategies, with a focus on polymer biomaterials as scaffolds for corneal endotlhelium regeneration. This review provides a comprehensive overview of the advancements in polymer biomaterials, focusing on their role in supporting the growth, differentiation, and functional maintenance of human corneal endothelial cells (CECs). Key properties of scaffold materials, including optical clarity, biocompatibility, biodegradability, mechanical stability, permeability, and surface wettability, are discussed in detail. The review also explores the latest innovations in micro- and nano-topological morphologies, fabrication techniques such as electrospinning and 3D/4D bioprinting, and the integration of drug delivery systems into scaffolds. Despite significant progress, challenges remain in translating these technologies to clinical applications. Future directions for research are highlighted, including the need for improved biomaterial combinations, a deeper understanding of CEC biology, and the development of scalable manufacturing processes. This review aims to serve as a resource for researchers and clinician–scientists seeking to advance the field of corneal endothelium tissue engineering.

Mechanical properties of stromal striae, and their impact on corneal tissue behavior

Cornea is an essential element of our eye. The refractive power of the cornea is closely related to its shape, which depends on the balance between its mechanical properties and the intraocular pressure. However, in keratoconus, the shape of the cornea is altered, and the mechanical properties (i.e., elastic modulus and viscosity) are reduced. These alterations have been associated with the development of striae within the cornea. Recently, such striae have been observed in healthy corneas as well, but with slightly different shapes. Our study investigated the mechanical role of these striae. To this end, we performed an inflation test under Optical Coherence Tomography: tomographic volumes were acquired in the central zone of eleven human corneas during an inflation test. Striae planes were extracted from the segmented images, and principal deformation maps were obtained by Digital Volume Correlation (DVC). We observe that the pattern of the striae does not change with pressure, even far above physiological pressure. Maximum principal strains are co-localized with the striae and are oriented perpendicular to the striae. We also observe that principal deformations on the striae increase with depth in the cornea. Our results show that striae lead to greater deformability in the direction perpendicular to the striae, especially in the posterior part of the cornea where they are the most visible. This supports the idea that the striae are undulations in the cornea collagenous microstructure, which are progressively unfolded under loading. They decrease the global stiffness of the cornea, in particular in the posterior part, and thus may help in accommodating deformations.

Effects of Eye Bank Donor Age Expansion on Corneal Endothelial Cell Density and Surgeon Tissue Acceptance

Effects of Eye Bank Donor Age Expansion on Corneal Endothelial Cell Density and Surgeon Tissue Acceptance

Multiphoton scaling of femtosecond laser-induced refractive index change (LIRIC) in hydrogels and rabbit cornea

To find optimal conditions for performing laser induced refractive index change (LIRIC) in living eyes with both safety and efficacy, we investigated multiphoton excitation scaling of this procedure in hydrogel and excised corneal tissue. Three distinct wavelength modalities were examined: high-repetition-rate (HRR) and low-repetition-rate (LRR) 405 nm systems, as well as 800 nm and 1035 nm systems, whose LIRIC-inducing properties are described for the first time. Of all the systems, LRR 405 nm-LIRIC was able to produce the highest phase shifts at the lowest average laser powers. Relative merits and drawbacks to each modality are discussed as they relate to future efforts towards LIRIC-based refractive error correction in humans.

Tissue engineering of Cornea via Type 1 Collagen Biomaterials – A perspective

Engineering corneal tissue has advanced significantly in recent years. Engineering a biocompatible, mechanically stable, and optically clear tissue presents significant engineering hurdles. Two fundamental strategies have been explored by scholars to address these issues: cell-based methods for controlling cells their own extracellular matrix and scaffold-based methods for supplying dense, transparent matrices for cell growth. Both approaches have had some level of success. Additionally, new developments in innervating a tissue-engineered construct have been developed. Future research must concentrate on enhancing the mechanical stability of engineered constructions and the host reaction to implantation. Type 1 Collagen Biomaterial has been used for the construction of scaffolds or implantation for the cornea repair. Various methods for fabrication of the scaffolds have been described and mentioned tissue engineering application for cornea repair and regeneration. Given this correspondence, the type 1 collagen was a potential biomaterial for tissue engineering scaffold fabrication for effective regeneration of cornea.

Fabrication and characterization of an electrospun silk fibroin/gelatin transparent graft material for corneal epithelial regeneration

The damaged corneal epithelial causing loss of vision can be restored by epithelial tissue regeneration through tissue engineering approach that provides an engineered corneal substitute with appropriate properties and nanofibrous architecture. This works reports a polymeric matrix that was derived from silk fibroin (SF) and gelatin (GE) natural polymer blend with optimized composition resembling the structure and function of the native epithelial tissue. SF/GE blend spinning solutions prepared with different volume ratios of SF/GE: 70/30, 50/50, and 30/70 were used to fabricate electrospun mats. The fabricated two-dimensional mats had nanofibrous porous architecture having interconnected pores with pore size range of 175–267 nm suitable for corneal epithelial regeneration and 891.2–558 nm fiber diameter range as revealed by scanning electron microscopic image analysis. The performed Fourier transform infrared spectra confirmed the presence of individual polymers in the scaffolds and the scaffolds are hydrophilic in nature. Among the scaffolds, SF/GE 70:30 and SF/GE 50:50 composition possess desired porosity range of 87–88%. The tensile strength was slightly decreased with increase in GE content and the strength obtained was in the range 2.74–2.26 Mpa. An enhanced transparency was obtained with increased GE concentration, the transparency range of 73–82% observed with SF/GE:50/50 matches with the transparency of natural corneal epithelium. The biocompatibility of the scaffolds was confirmed by cell attachment, cytotoxicity and ROS evaluation by culturing rabbit corneal fibroblast cells (SIRC) on the scaffolds. Among the scaffolds, SF/GE: 70/30 exhibited the highest cell viability, but with less transparency ranging 55–71%. Therefore, considering all the properties, SF/GE with 50:50 ratio scaffold may be a suitable substrate in the field of corneal tissue engineering.

304 (PB292): Effects of Nectin-4 targeted Bicycle Toxin Conjugate, zelenectide pevedotin (BT8009), and enfortumab vedotin on a human corneal tissue model

304 (PB292): Effects of Nectin-4 targeted Bicycle Toxin Conjugate, zelenectide pevedotin (BT8009), and enfortumab vedotin on a human corneal tissue model

Bufalin Regulates STAT3 Signaling Pathway to Inhibit Corneal Neovascularization and Fibrosis After Alkali Burn in Rats

Purpose Bufalin (BU) is a bioactive ingredient extracted from the skin and parotid venom glands of Bufo raddei, which can effectively inhibit angiogenesis. The aim of this study was to investigate whether BU could affect corneal neovascularization (CoNV). Methods A rat CoNV model (right eye) was constructed by administration of NaOH, and the left eye served as a control. Corneal damage scores of rats were detected. Hematoxylin & eosin, TUNEL, and Masson staining examined pathological changes, apoptosis, and fibrosis of corneal tissues. Immunohistochemistry and western blotting assessed the expression of proteins. Results BU intervention resulted in a significant reduction in corneal inflammatory cells, repair of corneal epithelial hyperplasia, significant reduction in stromal edema, and reduction in vascular proliferation. BU can inhibit corneal neovascularization. Conclusion This study demonstrated that BU inhibits CoNV, fibrosis, and inflammation by modulating the STAT3 signaling pathway, elucidating the intrinsic mechanism of its protective effect. BU has great potential in the treatment of CoNV caused by corneal alkali burns.

MUC1‑ND interacts with TRPV1 to promote corneal epithelial cell proliferation in diabetic dry eye mice by partly activating the AKT signaling pathway.

Although both mucin1 (MUC1) and transient receptor potential cation channel subfamily V member 1 (TRPV1) have been reported to be associated with dry eye (DE) disease, whether they interact and their regulatory roles in diabetic DE disease are unknown. Diabetic DE model mice were generated by streptozotocin induction and assessed by corneal fluorescein staining, tear ferning (TF) tests, phenol red thread tests, hematoxylin and eosin staining of corneal sections and periodic acid Schiff staining of conjunctival sections. Cell proliferation was measured by CCK8 assay. Western blotting was performed to measure protein expression. Primary mouse corneal epithelial cells (MCECs) were cultured after enzymatic digestion. Immunofluorescence staining of MCECs and frozen corneal sections was conducted to assess protein expression and colocalization. Coimmunoprecipitation was performed to detect protein‑protein interactions. It was found that, compared with control mice, diabetic DE mice exhibited increased corneal epithelial defects, reduced tear production, poorer TF pattern grades and impaired corneal and conjunctival tissues. In vivo and in vitro experiments showed that hyperglycemia impaired cell proliferation, accompanied by decreased levels of the MUC1 extracellular domain (MUC1‑ND) and TRPV1. Additionally, it was found that capsazepine (a TRPV1 antagonist) inhibited the proliferation of MCECs. Notably, MUC1‑ND was shown to interact with the TRPV1 protein in the control group but not in the diabetic DE group. It was also found that the AKT signaling pathway was attenuated in the diabetic DE mice and downstream of TRPV1. MUC1‑ND interacted with TRPV1, partly activating the AKT signaling pathway to promote MCEC proliferation. The present study found that the interaction of MUC1‑ND with TRPV1 promotes MCEC proliferation by partly activating the AKT signaling pathway, providing new insight into the pathogenesis of corneal epithelial dysfunction in diabetic DE disease.

Bio-spectroscopic analysis of corneal structural alterations in dry eye disease: A study of collagen, co-enzymes, lipids, and proteins with emphasis on phytotherapy intervention

Dry eye disease (DED) stands as a prevalent cause for ophthalmology consultations, securing the third position following refractive errors and cataracts. Moreover, the likelihood of experiencing DED escalates with advancing age. In this experimental study corneal tissue alterations due to DED were investigated over different periods by applying both infrared and synchronous fluorescence spectroscopy. The potential effects of instillation of pomegranate and green tea water extracts as green-friendly treatment modalities were also evaluated. The obtained results collectively indicate that DED affects the OH bearing constituents (collagen, glycosaminoglycans, and proteoglycans) of cornea leading to changes in protein secondary structure and the collagen fibrils. Additionally, enhanced dehydrated environment, and reduced energetic/metabolic state, as indicated by co-enzymes, was observed. Phyto-therapeutic administration can contain these alterations with enhanced energetic/metabolic state and increased hydration environment. In conclusion, instillation of green tea extract can protect/restore the collagen fibrils and its potential effects, in general, exceeds that of pomegranate extract.