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Related Experiment Video

Updated: Oct 13, 2025

Ex Vivo Corneal Organ Culture Model for Wound Healing Studies
06:46

Ex Vivo Corneal Organ Culture Model for Wound Healing Studies

Published on: February 15, 2019

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Epithelial Flap Corneal Cross-linking.

Davide Borroni, Chiara Bonzano, Rozaliya Hristova

    Journal of Refractive Surgery (Thorofare, N.J. : 1995)
    |November 10, 2021
    PubMed
    Summary

    Corneal cross-linking with an epithelial flap (Epi-Flap CXL) offers reduced postoperative pain and anterior corneal haze compared to standard epithelium-off CXL for keratoconus. This technique maintains the efficacy of standard CXL in stabilizing the cornea.

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    Corneal Epithelial Abrasion with Ocular Burr As a Model for Cornea Wound Healing
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    Area of Science:

    • Ophthalmology
    • Corneal Surgery
    • Vision Science

    Background:

    • Keratoconus is a progressive condition causing corneal thinning and irregular astigmatism.
    • Corneal cross-linking (CXL) is a standard treatment to halt keratoconus progression.
    • Standard epithelium-off CXL (Epi-Off CXL) is effective but can be associated with significant postoperative discomfort and haze.

    Purpose of the Study:

    • To compare the outcomes of standard Epi-Off CXL with a novel Epi-Flap CXL technique.
    • To evaluate postoperative pain and corneal haze following both CXL procedures.
    • To assess the efficacy of Epi-Flap CXL in stabilizing progressive keratoconus.

    Main Methods:

    • A comparative interventional case series involving 12 patients with progressive keratoconus.
    • Sequential bilateral CXL was performed, with one eye receiving Epi-Off CXL and the fellow eye receiving Epi-Flap CXL.
    • Postoperative pain was assessed using the Verbal Rating Scale, and corneal haze was quantified using densitometry.

    Main Results:

    • Epi-Flap CXL demonstrated significantly lower Verbal Rating Scale scores on postoperative days 1 and 3 compared to Epi-Off CXL.
    • Anterior corneal haze, measured by densitometry, was significantly reduced in the Epi-Flap CXL group after 12 months.
    • Both Epi-Flap CXL and Epi-Off CXL groups showed stable keratometry and corneal thickness at 12 months, indicating preserved efficacy.

    Conclusions:

    • Epi-Flap CXL is a viable alternative to standard Epi-Off CXL for progressive keratoconus.
    • The Epi-Flap CXL technique offers improved patient comfort and reduced corneal haze post-procedure.
    • Epi-Flap CXL provides comparable efficacy to standard Epi-Off CXL in halting keratoconus progression.