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Nandor Bekesi, Irene E. Kochevar, Susana Marcos; Corneal
Biomechanical Response Following Collagen Cross-Linking With Rose
Bengal–Green Light and Riboflavin-UVA. Invest. Ophthalmol. Vis. Sci. 2016;57(3):992-1001. doi: 10.1167/iovs.15-18689.
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© 2016 Association for Research in Vision and Ophthalmology.
To compare the biomechanical corneal response of two
different corneal cross-linking (CXL) treatments, rose bengal–green
light (RGX) and riboflavin-UVA (UVX), using noninvasive imaging.
A total of 12 enucleated rabbit eyes were treated with RGX
and 12 with UVX. Corneal dynamic deformation to an air puff was measured
by high speed Scheimpflug imaging (Corvis ST) before and after
treatment. The spatial and temporal deformation profiles were evaluated
at constant intraocular pressure of 15 mm Hg, and several deformation
parameters were estimated. The deformation profiles were modeled
numerically using finite element analysis, and the hyperelastic corneal
material parameters were obtained by inverse modeling technique.
The corneal deformation amplitude decreased significantly
after both CXL methods. The material parameters obtained from inverse
modeling were consistent with corneal stiffening after both RGX and UVX.
Within the treated corneal volume, we found that the elasticity
decreased by a factor of 11 after RGX and by a factor of 6.25 after UVX.
The deformation of UVX-treated corneas was smaller than the
RGX-treated corneas. However, the reconstructed corneal mechanical
parameters reveal that RGX produced in fact larger stiffening of the
treated region (100-μm depth) than UVX (137-μm depth). Rose bengal–green
light stiffens the cornea effectively, with shorter treatment times and
shallower treated areas. Dynamic air puff deformation imaging coupled
with mechanical simulations is a useful tool to characterize corneal
biomechanical properties, assess different treatments, and possibly help
optimize the treatment protocols.
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