Topography-guided, patterned, customized corneal crosslinking for non-invasive astigmatism correction

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Corneal Surgery

Background:

• Corneal astigmatism poses a significant challenge in vision correction.
• Current treatments may be invasive or lack long-term stability.
• Topography-guided corneal collagen crosslinking (CXL) offers a potential non-invasive solution.

Purpose of the Study:

• To propose and evaluate a novel, non-invasive approach for enduring corneal astigmatism correction.
• To utilize topography-guided, patterned riboflavin-ultraviolet A corneal collagen crosslinking (CXL).
• To assess the long-term effectiveness, stability, and safety of this customized CXL procedure.

Main Methods:

• Corneal astigmatism was surgically induced in rabbit eyes.
• A novel, self-built intelligent platform delivered patterned ultraviolet A in a lattice manner based on pre-operative corneal topography.
• Effectiveness, stability, and safety were evaluated over 180 days using topographic measurements, AS-OCT, and IVCM.

Main Results:

• Spatially selective crosslinking was confirmed via AS-OCT and IVCM.
• Significant reductions in astigmatic magnitude (0.46 ± 0.28 D) and high-order aberrations (0.38 ± 0.18) were observed.
• Visual quality, indicated by an increased Strehl ratio (0.21 ± 0.06), improved and was maintained for 180 days.
• No significant opacity or inflammation occurred; transient endothelial cell loss resolved.

Conclusions:

• The proposed topography-guided, patterned CXL is a safe and effective non-invasive method for corneal astigmatism correction.
• This novel approach successfully improved visual quality and reduced high-order aberrations.
• The customized CXL procedure demonstrated long-term stability and safety in preclinical evaluation.