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Transepithelial riboflavin-UVA corneal cross-linking biomechanical and cell death superiority to traditional epithelium-off CXL in a rabbit model

Session Details

Session Title: Cross-linking

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 14:36

Venue: Elicium 2 (First Floor)

First Author: : S.Wilson USA

Co Author(s): :    B. Armstrong   M. Lin   M. Ford   A. Torricelli   M. Santhiago   W.

Abstract Details

Purpose:

To compare the biological and biomechanical effects of riboflavin-UVA corneal crosslinking performed with a traditional epithelium-off method to a BKC-EDTA transepithelial methods in a rabbit model.

Setting:

Laboratory based-animal study in rabbits

Methods:

Benzalkonium chloride-EDTA (BKC-EDTA) transepithelial and standard epithelium-off riboflavin-UVA corneal crosslinking was performed in six eyes each and compared to control untreated eyes at 24 hours and two months after treatment with the TUNEL assay for cell death. The corneal stiffening effect was initially quantitated in three eyes in each group using optical coherence elastography performed at two months after the treatments. A follow-up study of stiffness at two months included eleven eyes in each group.

Results:

At 24 hours after CXL, stromal cell death extended full corneal thickness in the standard epithelium-off CXL eyes, including endothelial cells in each cornea, but consistently extended only approximately 1/3 stromal depth after BKC-EDTA transepithelial CXL, with no endothelial cell death. No stromal or endothelial cell death was detected in the control untreated group. As measured with optical coherence elastography, a trend toward greater mean stiffening was observed with BKC-EDTA transepithelial CXL compared with epithelium-off CXL in the preliminary study with three eyes in each group. The follow-up study with eleven eyes in each group confirmed greater biomechanical stiffening in the BKC-EDTA transepithelial CXL group. Both CXL treatment groups exhibited significantly smaller variance of stiffness compared to the control group.

Conclusions:

In the rabbit model, BKC-EDTA transepithelial CXL produces less stromal cell death and less risk of endothelial cell damage than standard epithelium-off CXL. BKC-EDTA transepithelial CXL also produces greater biomechanical stiffening than traditional epithelium-off CXL at two months after treatment.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company