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Biomechanical efficacy of corneal cross-linking using hypoosmolar riboflavin solution.

A new interesting article has been published in Eur J Ophthalmol. 2018 Sep 26:1120672118801130. doi: 10.1177/1120672118801130. and titled:

Biomechanical efficacy of corneal cross-linking using hypoosmolar riboflavin solution.

Authors of this article are:
Wollensak G Spörl E.

A summary of the article is shown below:
PURPOSE: The use of hypoosmolar riboflavin solution has been suggested for cross-linking thin corneas. The aim of this study was to compare the biomechanical efficacy of corneal cross-linking using hypoosmolar dextran-free riboflavin solution (HCXL) versus isoosmolar standard corneal cross-linking treatment (CXL).METHODS: A total of 24 postmortem porcine eyes with debrided corneas were subdivided into three treatment groups: Controls, the isoosmolar group with isoosmolar 0.1% riboflavin-20% dextran solution and the hypoosmolar group with dextran-free, 0.1% riboflavin solution. The samples were irradiated with UVA light of 365 nm wavelength and an irradiance of 3 mW/cm² for 30 min (dose 5.4 J/cm²). For the biomechanical measurements, 400-µm-deep anterior corneal flaps were created using a lamellar rotating microkeratome. Uniaxial stress-strain measurements were performed.RESULTS: In the isoosmolar treatment group, stress and Young’s modulus at 8% strain were significantly increased by 67.97%, respectively, 62.62% versus the controls. In the hypoosmolar treatment group, stress and Young’s modulus at 8% strain were significantly increased by 81.21%, respectively, 51.40% versus the controls. There was no significant difference between the iso- and hypoosmolar groups in biomechanical efficacy. On histology, there was no edema in the anterior 200 µm of the corneas after stromal swelling by the hypoosmolar riboflavin solution.CONCLUSION: Corneal cross-linking using isoosmolar or hypoosmolar riboflavin solution induces a comparable biomechanical effect. This is explained by the localization of the maximum cross-linking effect in the anterior 200 µm of the cornea which are not affected by the swelling effect of hypoosmolar riboflavin solution.

Check out the article’s website on Pubmed for more information:



This article is a good source of information and a good way to become familiar with topics such as: CXL;Cornea;UVA;cross-linking;hypoosmolar riboflavin solution;thin cornea.

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