Hydration behavior of porcine cornea crosslinked with riboflavin and ultraviolet A

Abstract

Collagen crosslinking using riboflavin and UVA led to a significant change in the swelling behavior of the anterior stroma, confirming prior findings that the crosslinking effect is strongest in the anterior half of the stroma. Crosslinked cornea did not induce a specific signal on OCT, and OCT is therefore not suited for clinical controls of the crosslinking effect.

Determination of the Excimer Laser Ablation Rate in Previously Cross-linked Corneas

“…20 CXL changes several properties of the corneal stroma, including the packing density of stromal collagen, its ability to swell, and the permeability to pharmacological substances. [21][22][23] One might speculate whether CXL might also influence the excimer laser ablation rate of the stroma. If this were the case, then nomograms would be needed to adjust the fluence per pulse (or the number of pulses for constant fluence) delivered by the excimer laser to ablate a defined amount of tissue.…”

“…This might be explained by the fact that CXL significantly reduces the stromal swelling capacity, reducing the depth-dependent differences in the hydration state of the cornea. 23,33 Another explanation might be the creation of additional crosslinks between proteoglycans and collagen in the anterior stroma during CXL. 34,35 To break these additional bonds, additional energy is needed.…”

Collagen crosslinking with ultraviolet-A and hypoosmolar riboflavin solution in thin corneas

“…[7][8][9][10] Before the first application in humans in 1999, 3 the parameters of the method (riboflavin concentration, intensity and wavelength of UVA light, and duration of treatment) were established in a series of time-and dose-response assays in animal models over several years. [2][3][4][11][12][13][14] To protect the corneal endothelium and deeper ocular structures, the currently used treatment parameters are set so the anterior 250 to 350 mm of corneal stroma are treated. 15 Accordingly, the current inclusion criteria require a minimum stromal thickness (without the corneal epithelium) of 400 mm, including a safety margin.…”

Effect of Corneal Collagen Cross-Linking on Quality of Life in Patients with Bullous Keratopathy

“…CXL re- duces this corneal edema by inducing more concentrated cross-linked fibers and reducing possible gaps for fluid accumulation. [5][6][7][8] Bullous keratopathy is one of the leading indications for keratoplasty all over the world. 6,9 Although, the main indication for keratoplasty in these patients is visual loss due to hazy cornea, the secondary indication for keratoplasty is the disabling pain that restricts their daily life.…”