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Updated: Aug 1, 2026

Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Investigating the effect of different riboflavin concentrations on corneal biomechanical properties in crosslinking
Xueqi Lin1, Shichu Liu, Jiayue Yuan
1From the Shanghai Institute of Infectious Disease and Biosecurity, Zhongshan Hospital, Fudan University, Shanghai, China (Lin, Dai); Department of Ophthalmology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China (Lin, Liu, Yuan, Cong, Q. Feng, C. Feng, Dai); Bengbu Medical University, Bengbu, Anhui, China (Xie); Basic Medical Experimental Teaching Center, Fudan University, Shanghai, China (Yan, Rao); Department of Ophthalmology, Eye & ENT Hospital Affiliated to Fudan University, Shanghai, China (Zhou).
Purpose:
To evaluate the corneal crosslinking (CXL) efficacy of riboflavin (RF) at 5 different concentrations (0.1%, 0.25%, 0.5%, 0.75%, and 1.0%) and determine the optimal concentration for maximizing the cornea's biomechanical performance.
Setting:
Department of Ophthalmology, Zhongshan Hospital, Fudan University.
Design:
Experimental study.
Methods:
The corneal epithelium was removed from all eyes. In the first part, 0.1% to 1.0% RF solutions were applied to rabbit eyes for 30 minutes, with 20% dextran used as the vehicle for the RF solutions. After application, RF concentration in the cornea and aqueous humor were evaluated. In the second part, after applying different RF solutions, the corneas underwent CXL with 9 mW/cm 2 UV-A light for 10 minutes. Stress-strain curves, Young modulus, and resistance to enzymatic digestion were measured.
Results:
107 eyes were used in total. RF concentrations in the cornea were 447.57 ± 28.72 μg/g, 536.51 ± 19.59 μg/g, 885.89 ± 111.77 μg/g, 1280.46 ± 103.86 μg/g, and 1668.68 ± 89.02 μg/g from 0.1% to 1.0% RF solutions, respectively. After CXL, the corneal stress of the other 4 groups was 123%, 147%, 116%, and 69% relative to the 0.1% RF group at 10% strain. Similarly, after CXL with RF solutions at 5 concentrations, the residual corneal dry weights were 0.45 ± 0.08 mg, 0.53 ± 0.03 mg, 0.62 ± 0.07 mg, 0.50 ± 0.04 mg, and 0.35 ± 0.05 mg, respectively.
Conclusions:
The 0.5% RF group achieved the optimal corneal biomechanical performance under controlled experimental conditions, with decreased efficiency as the RF concentration further increased.
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