METHODS TO INCREASE PERMEABILITY OF CORNEAL EPITHELIUM AND DESTABILIZE STROMAL COLLAGEN FIBRIL NETWORK
Methods of increasing the permeability of corneal epithelium to facilitate the diffusion of agents into the collagen fibrillar network of the stroma are provided. Used in combination, these methods open the epithelium to facilitate diffusion of stabilization molecules into the stroma and dissociate bridging molecules from stromal collagen fibers, thereby priming the collagen fibrillar network for restabilization by stabilization molecules. These methods can be used to increase the effectiveness and longevity of non-invasive corneal reshaping, such as orthokeratology, for correcting myopia, hyperopia and astigmatism.
1 . A method of stabilizing the shape of a cornea, wherein the method comprises applying to the cornea an agent that disrupts the corneal epithelial junctures (“disrupting agent”) and applying to the cornea an agent that dissociates the molecular bridges between stromal collagen fibers (“dissociating agent”); then applying an agent that restabilizes the stromal collagen network to thereby stabilize the shape of the cornea.
2 . The method of claim 1 , wherein the cornea has been reshaped using an orthokeratology procedure.
3 . The method of claim 1 , wherein the disrupting agent is an anhydride and the dissociating agent is an anhydride, an acid chloride, a sulfonyl chloride, or a sulfonic acid.
4 . The method of claim 3 , wherein the disrupting agent is chosen from maleic anhydride, succinic anhydride, glutaric anhydride, citractonic anhydride, methyl succinic anhydride, itaconic anhydride, methyl glutaric anhydride, dimethyl glutaric anhydride, or phthalic anhydride.
5 . The method of claim 3 , wherein the dissociating agent is chosen from acetic anhydride, butyric anhydride, or propionic anhydride.
6 . The method of claim 1 , wherein the stabilizing agent is decorin, biglycan, keratocan, lumican, mimican, fibromodulin, Type VI collagen, Type X collagen, Type XII collagen, or Type XIV collagen.
7 . The method of claim 6 , wherein the stabilizing agent is human recombinant decorin.
8 . A method of enhancing ocular drug delivery, comprising applying to the cornea an agent that disrupts the corneal epithelial junctures before applying the ocular drug.
9 . The method of claim 8 , further comprising applying to the cornea an agent that dissociates the molecular bridges between stromal collagen fibers before applying the ocular drug.
10 . The method of claim 8 , wherein the agent that disrupts the epithelium is chosen from maleic anhydride, succinic anhydride, glutaric anhydride, citractonic anhydride, methyl succinic anhydride, itaconic anhydride, methyl glutaric anhydride, dimethyl glutaric anhydride, or phthalic anhydride.
11 . The method of claim 8 , wherein the ocular drug is a hydrophilic drug.