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Interface Bonding With Corneal Crosslinking (CXL) After LASIK Ex Vivo
Theo G Seiler1,2,3, Marleen Engler1, Eric Beck1
1Wellman Center for Photomedicine-Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States.
Investigative Ophthalmology & Visual Science
|December 16, 2017
Summary
Corneal crosslinking (CXL) after LASIK using rose bengal or riboflavin enhances flap adhesion. Optimized parameters significantly increased shear-force, suggesting potential for improved LASIK outcomes.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Materials Science
Background:
- Laser-Assisted In Situ Keratomileusis (LASIK) is a common refractive surgery.
- Post-LASIK flap adherence is crucial for visual outcomes and stability.
- Corneal crosslinking (CXL) is a technique to strengthen corneal tissue.
Purpose of the Study:
- To investigate interface bonding after LASIK using corneal crosslinking (CXL).
- To compare the efficacy of two photosensitizers, rose bengal and riboflavin, for interface CXL.
- To determine optimal parameters for CXL to enhance LASIK flap adhesion ex vivo.
Main Methods:
- LASIK flaps were created in rabbit eyes using a femtosecond laser.
- Interface CXL was performed using either rose bengal with green light or riboflavin with UV-A light.
- Parameters such as irradiance, radiant exposure, dye concentration, and imbibition time were varied.
- Maximal shear-force was measured to assess flap adhesion; corneal transmission spectra were recorded.
Main Results:
- Optimized rose bengal/green-light CXL increased shear-force 2.1-fold compared to controls (P < 0.01).
- Optimized riboflavin/UV-A light CXL increased shear-force 2-fold compared to controls (P < 0.01).
- Optimal parameters for rose bengal included 0.1% dye, 180 mW/cm2 irradiance for 14 min (150 J/cm2), and 2 min imbibition.
- Optimal parameters for riboflavin included 0.5% dye, 30 mW/cm2 irradiance for 4.5 min (8.1 J/cm2), and 2 min imbibition.
- Corneal transmission spectra indicated safety for posterior structures.
Conclusions:
- Ex vivo results demonstrate that CXL with rose bengal or riboflavin enhances LASIK flap-stromal bed adhesion.
- The study identified optimized parameters for both photosensitizer systems.
- Further in vivo trials are necessary to assess the long-term effects and clinical applicability.
