Methods for cross-linking corneal collagen with verteporfin for the treatment of disorders of the eye
Described are compositions and methods of using verteporfin-based photodynamic therapy (PDT) to increase the biomechanical strength of the cornea. More particularly, described herein are compositions and methods for cross-linking collagen in corneal tissue which are useful in the treatment of corneal ectatic disorders.
1. A method for increasing corneal rigidity in a subject, comprising:
identifying a subject who has keratoconus, pellucid marginal degeneration, post-operative ectasia or who has refractive defects and plans to undergo a refractive surgical procedure at a later time;
topically administering an effective amount of a composition comprising verteporfin to the cornea of the subject; and
irradiating the cornea with non-thermal laser light with a wavelength of 687 nm to 693 nm, wherein the administering and irradiating steps are repeated for a total of at least six times,
wherein the irradiating step comprises continuous exposure to non-thermal laser light for 30 to 60 seconds in duration, and targeting the non-thermal laser light to a depth within the cornea in a range of 50 microns to 500 microns.
2. The method of claim 1 , wherein the refractive surgical procedure is radial keratotomy (RK), photorefractive keratectomy (PRK), or laser in-situ keratomileusis (LASIK).
3. The method of claim 1 , wherein the verteporfin composition is a lotion, gel, cream, ointment, solution, spray, paste or aerosol composition.
4. The method of claim 1 , wherein topically administering a composition comprising verteporfin comprises applying eye drops comprising a verteporfin solution to the surface of the cornea.
5. The method of claim 1 , further comprising determining the amount of collagen cross-linking in the cornea.
6. The method of claim 1 , wherein the verteporfin composition comprises 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5, 6.0, 6.5, 7.0, 7.5, 8.0, 8.5, 9.0, 9.5, or 10.0 mg/ml of verteporfin.
7. The method of claim 1 , wherein the composition comprising verteporfin is administered to the cornea one to twenty minutes, one to ten minutes, ten to twenty minutes, two to nine minutes, three to seven minutes, four to six minutes, or four to five minutes prior to irradiating the corneal with a non-thermal laser.
8. The method of claim 1 , wherein the non-thermal laser light has an intensity in a range of 200 mW/cm 2 to 650 mW/cm 2 , or in a range of 575 mW/cm 2 to 625 mW/cm 2 .
9. The method of claim 1 , wherein the irradiating step comprises targeting the non-thermal laser light to a depth within the cornea in a range of 100 microns to 450 microns, 150 microns to 400 microns, 200 microns to 350 microns, 250 microns to 300 microns, 50 microns to 250 microns, or 250 microns to 500 microns.
10. A method for increasing corneal rigidity in a subject, comprising:
(a) identifying or having identified a subject who has keratoconus, pellucid marginal degeneration, post-operative ectasia or who has refractive defects and plans to undergo a refractive surgical procedure at a later time;
(b) topically administering an effective amount of a composition comprising verteporfin to the cornea of the subject for 15 minutes;
(c) irradiating the cornea with non-thermal laser light with a wavelength of 687 nm to 693 nm for 60 seconds;
wherein step (c) is repeated for a total of six times, and wherein an effective amount of the composition comprising verteporfin is administered to the cornea before each time step (c) is repeated.