Enhancing Rose Bengal penetration in <i>ex vivo</i> human corneas using iontophoresis
James M Lai, Justin Chen, Juan Carlos Navia, Heather Durkee, Alex González, Cornelis Rowaan, Timothy Arcari, Mariela C Aguilar, Katrina Llanes, Noël Ziebarth, Jaime D. Martinez, Darlene Miller, Harry W. Flynn, Guillermo Amescua, Jean–Marie Parel
Abstract
Aim: Rose Bengal photodynamic antimicrobial therapy (RB-PDAT) has poor corneal penetration, limiting its efficacy against acanthamoeba keratitis (AK). Iontophoresis enhances corneal permeation of charged molecules, piquing interest in its effects on RB in ex vivo human corneas. Methods: Five donor whole globes each underwent iontophoresis with RB, soaking in RB, or were soaked in normal saline (controls). RB penetration and corneal thickness was assessed using confocal microscopy. Results: Iontophoresis increased RB penetration compared with soaking (177 ± 9.5 μm vs. 100 ± 5.7 μm, p < 0.001), with no significant differences in corneal thickness between groups (460 ± 87 μm vs. 407 ± 69 μm, p = 0.432). Conclusion: Iontophoresis significantly improves RB penetration and its use in PDAT could offer a novel therapy for acanthamoeba keratitis. Further studies are needed to validate clinical efficacy.