Techniques for stiffening the cornea

In keratoconus, corneal stiffness is decreased. The purposes of this study were to search for techniques to stiffen the cornea and to determine a dose-response relation. The stiffness of collagenous tissues can be increased by cross-linking. Cross-linking techniques--riboflavin and ultraviolet irradiation (365 nm, 2 mW/cm2, 45 min), glutaraldehyde of low concentration, and several aldehyde sugars--were tested on corneas of enucleated porcine eyes. The stress-strain relation was measured and compared to untreated corneas. Aldehyde sugars produced cross-links by nonenzymatic glycation only after a prolonged time (realized in diabetics). Riboflavin and UV seems to be a promising technique to stabilize the cornea by artificial cross-linking.