Selective Equatorial Sclera Crosslinking in the Orbit Using a Metal-Coated Polymer Waveguide

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Materials Science

Background:

• Pathologic myopia involves excessive eye elongation.
• Scleral stiffening via photochemical crosslinking is a potential treatment.
• Uniform light delivery to the sclera is a significant challenge.

Purpose of the Study:

• To demonstrate advanced flexible polymer waveguides for targeted light delivery to the equatorial sclera.
• To overcome limitations in light delivery for scleral crosslinking in the intact orbit.

Main Methods:

• Developed polydimethylsiloxane-clad, polyurethane-core waveguides with reflective silver coating.
• Tested in situ equatorial sclera crosslinking in postmortem rabbit eyes.
• Performed ex vivo tensometry to measure biomechanical stiffening.

Main Results:

• Achieved efficient light delivery to the equatorial sclera with minimal periorbital leakage.
• Demonstrated a 22% coefficient of variation in light intensity in the intact orbit.
• Observed a 92% increase in Young's modulus (P < 0.05) in ex vivo crosslinked eyes.

Conclusions:

• Flexible, reflective waveguides facilitate targeted scleral crosslinking.
• The demonstrated procedure shows potential for in vivo application in animal models and humans.
• This technique may offer a novel approach to managing pathologic myopia.