Purpose:

Infectious keratitis is a common prelude for the development of corneal perforation. The increased incidence of drug resistant ocular pathogens has led to explore innovative approaches to combat the stromal melting. We highly our new riboflavin conjugate in combination with ultraviolet light A (UVA) in vivo as a novel therapy for this condition.

Methods:

The left corneal stroma of thirty-six, female and male New Zealand Albino rabbits (3-5-month-old), was inoculated with a suspension of a multidrug resistant-methicillin resistant S. aureus strain. The corneas were randomly divided: 1) new riboflavin conjugate + UVA, 2) riboflavin + UVA, 3) moxifloxacin eyedrops and 4) negative controls. All eyes were clinically examined at day 0 (before any treatment) and daily after inoculation. All eyes were sent for microbiological and histopathological examination 3h, 24h and 2 weeks after treatments. The left corneas were also assessed for endothelial cell vitality. P < 0.05="" was="" considered="" statistically="" significant.="" 0.05="" was="" considered="" statistically="" />

Results:

Clinical improvement was beyond significant with the new riboflavin conjugate + UVA compared to the rest of treatments. The difference in the CFU count between the new riboflavin conjugate + UVA and the other groups was statistically significant with 0 CFU (P ≤ 0.00243). There was no endothelial cell damage in the rabbits’ eyes enucleated at 3h, 24 h and 2 weeks after the new riboflavin conjugate + UVA administration.

Conclusions:

Our novel riboflavin conjugate (BPerox) photoactivated by UVA is powerful in restoring corneal integrity and transparency, without compromising the corneal endothelium. Its mechanism of action might be multitarget and orchestrated by the production of reactive oxygen species.