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The Evaluation of Corneal Fragility After UVA/Riboflavin Crosslinking
Zhiwei Li1, Yumeng Wang, Yanyun Xu
1Department of Ophthalmology (Z.L., Y.W., Y.X., C.Z., G.M.), Shandong Provincial Hospital affiliated to Shandong University, Jinan, China; and Department of Ophthalmology and Visual Sciences (V.J.), The Chinese University of Hong Kong, Hong Kong, China.
Purpose:
To evaluate the fragility of cornea after UVA/riboflavin crosslinking (CXL).
Methods:
Sixty New Zealand rabbits received UVA/riboflavin crosslinking treatment (wavelength 365 nm, irradiance 3.0 mW/cm, and total dose 5.4 J/cm) on right eyes. Animals were sacrificed before and immediately after treatment (day 0), day 1, 3, 7, and 28 after treatment. A 4×10 mm corneal strip for biomechanical evaluation was harvested after sacrifice. The corneal fragility was evaluated by measurement of elongation rate, whereby the elongation rate equals elongation length/baseline length.
Results:
The Youngs modulus and maximal stress were 1.41±0.51 MPa and 5.56±1.84 MPa before CXL, and increased to 2.31±0.68 MPa (P=0.008) and 9.25±2.74 MPa (P=0.04), respectively, on day 0, then maintained a stable level within a 28 days follow-up. The elongation rate was 62.04±9.34% before CXL and decreased to 48.95%±8.24% (P=0.02) on day 0, then maintained a stable level within a 28 days follow-up.
Conclusions:
This study showed an increase in the corneal fragility after UVA/riboflavin crosslinking along with an increase in the corneal stiffness. A long-term follow-up should be taken to evaluate the potential deleterious effect of the increasing corneal fragility after UVA/riboflavin crosslinking.
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