Oxygen-releasing microneedles enhance the therapeutic effect of corneal ectasia by increasing corneal oxygen content and riboflavin concentration during cross-linking
2025
Xueqi Lin | Wei Hu | Jiayue Yuan | Shichu Liu | Zhenghong Ge | Shangpeng Liu | Jing Cong | Qianhong Feng | Hao Li | Chenli Feng | Min Sun | Zhen Fan | Jinhui Dai
Corneal ectasia, characterized by progressive corneal thinning and reduced biomechanical properties, significantly impairs patients' visual quality. The epithelium-off (epi-off) procedure, the gold standard for treating corneal ectasia, avoids corneal transplantation but can cause pain and delayed healing. In contrast, trans-epithelial therapy preserves the epithelium but suffers from limited riboflavin penetration, reducing its efficacy. Furthermore, corneal cross-linking (CXL) is oxygen-dependent, and rapid oxygen depletion in the corneal stroma significantly limits the CXL efficacy. To alleviate oxygen deficiency in the corneal stroma during CXL, enhance riboflavin penetration, and reduce the side effects of epi-off therapy, novel oxygen-releasing riboflavin microneedles (O2RF@MNs) are developed. The corneal biomechanical properties of O2RF@MNS are 121 % of those of conventional RF@MNs (without oxygen release) and 207 % of the 0.1 % epi-off therapy. Furthermore, corneas treated with O2RF@MNs show reduced inflammation and pain compared to the epi-off therapy, along with increased riboflavin penetration. Additionally, O2RF@MNs can mitigate corneal ectasia progression by inhibiting MMP2 expression. These findings suggest that O2RF@MNs represent a promising therapeutic strategy for managing corneal ectasia.
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