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Bret A. Moore, Soohyun Kim, Iman Jalilian, monica motta, Madison Mukai, Makiko Mizutani, Christopher J Murphy, Sara M Thomasy; Effects of corneal collagen crosslinking on stromal wound healing using a rabbit phototherapeutic keratectomy model. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1398.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effects of corneal collagen crosslinking (CXL) on stromal wound healing following phototherapeutic keratectomy (PTK) using an in vivo rabbit model.
New Zealand white rabbits (n=32) underwent epithelial debridement and PTK of the right eye. Sixteen rabbits were randomly selected to undergo a CXL procedure using 0.1% riboflavin sodium phosphate and UVA light (365nm, irradiance 3.0mW/cm2); the remaining 16 rabbits served as a control. Wound healing was monitored using Fourier-Domain optical coherence tomography (FD-OCT), slit lamp biomicroscopy, and in vivo confocal microscopy at days 7, 21, 42, 70, and 90 post-operative. Rabbits were euthanized at either day 21 or 90 post-operative. Characterization of tissue biomechanics were assessed by atomic force microscopy.
Epithelial wound healing did not significantly differ between CXL and non-CXL groups. Stromal haze thickness (mean ± SD) measured on FD-OCT was significantly different between CXL and non-CXL groups, respectively occupying 85% ± 4% compared to 30% ± 18% of the total corneal thickness at Day 21 (P<0.01), and 70% ± 26% versus 24% ± 6% at Day 90 (P<0.01). Mean ± SD matrix stiffness was significantly greater (P<0.01) for the CXL group (5.5 ± 0.8 kPa) compared to the non-CXL group (2.0 ± 0.6 kPa) at Day 21, but a non-significant positive trend (P = 0.25) was detected at Day 90 between CXL (2.4 ± 0.4 kPa) and non-CXL (2.0 ± 0.4 kPa).
The CXL dramatically increased the elastic modulus and stromal haze formation in response to corneal wounding (PTK). Although CXL procedures are commonly performed in conjunction with keratorefractive surgeries in human patients. Further studies are required to determine whether or not the results found here are a species difference in response to CXL therapy, or whether human patients are at increased risk of corneal scar formation. Additionally, future studies should evaluate the duration of changes to stromal compliance following CXL treatment and the interaction between CXL and PTK when the procedures occur at different time points versus simultaneously.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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