Experimental Use of Ozone in Cross-Linking: Transforming Keratoconus Management

Area of Science:

• Ophthalmology
• Biomaterials Science
• Regenerative Medicine

Background:

• Keratoconus is a progressive corneal disease causing stromal thinning.
• Corneal cross-linking (CXL) strengthens corneas by increasing collagen cross-links.
• Research is ongoing to enhance CXL efficacy.

Purpose of the Study:

• To evaluate ozone as an adjuvant or standalone cross-linking agent for keratoconus in an in vivo model.
• To assess ozone's potential to improve corneal strength and CXL efficacy.

Main Methods:

• 12 New Zealand albino rabbits were divided into three groups: CXL, ozone, and CXL+ozone.
• Corneal biomechanics were assessed using Corneal Visualization Scheimpflug Technology (Corvis ST).
• Anterior Segment Optical Coherence Tomography (AS-OCT) and Corneal Confocal Microscopy (CCM) were utilized for imaging.

Main Results:

• Ozone therapy demonstrated comparable biomechanical outcomes to CXL.
• AS-OCT showed stromal brightness in the CXL+ozone group.
• CCM revealed enhanced stromal hyperreflectivity with CXL+ozone compared to standalone treatments. No adverse effects were noted.

Conclusions:

• Ozone therapy may enhance CXL efficacy and presents a viable alternative treatment for keratoconus.
• Its cost-effectiveness and shorter treatment duration are advantageous, especially in resource-limited settings.