Flexible Optical Waveguides for Uniform Periscleral Cross-Linking.

Kwok, Sheldon J J; Kim, Moonseok; Lin, Harvey H; Seiler, Theo G; Beck, Eric; Shao, Peng; Kochevar, Irene E; Seiler, Theo; Yun, Seok-Hyun (2017). Flexible Optical Waveguides for Uniform Periscleral Cross-Linking. Investigative ophthalmology & visual science, 58(5), pp. 2596-2602. Association for Research in Vision and Ophthalmology 10.1167/iovs.17-21559

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Purpose Scleral cross-linking (SXL) with a photosensitizer and light is a potential strategy to mechanically reinforce the sclera and prevent progressive axial elongation responsible for severe myopia. Current approaches for light delivery to the sclera are cumbersome, do not provide uniform illumination, and only treat a limited area of sclera. To overcome these challenges, we developed flexible optical waveguides optimized for efficient, homogeneous light delivery. Methods Waveguides were fabricated from polydimethylsiloxane elastomer. Blue light (445 nm) is coupled into the waveguide with an input fiber. Light delivery efficiency from the waveguide to scleral tissue was measured and fit to a theoretical model. SXL was performed on fresh porcine eyes stained with 0.5% riboflavin, using irradiances of 0, 25, and 50 mW/cm2 around the entire equator of the eye. Stiffness of scleral strips was characterized with tensiometry. Results Light delivery with a waveguide of tapered thickness (1.4-0.5 mm) enhanced the uniformity of light delivery, compared to a flat waveguide, achieving a coefficient of variation of less than 10%. At 8% strain, sclera cross-linked with the waveguides at 50 mW/cm2 for 30 minutes had a Young's modulus of 10.7 ± 1.0 MPa, compared to 5.9 ± 0.5 MPa for no irradiation, with no difference in stiffness between proximally and distally treated halves. The stiffness of waveguide-irradiated samples did not differ from direct irradiation at the same irradiance. Conclusions We developed flexible waveguides for periscleral cross-linking. We demonstrated efficient and uniform stiffening of a 5-mm-wide equatorial band of scleral tissue.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Seiler, Günter Theodor Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0146-0404

Publisher:

Association for Research in Vision and Ophthalmology

Language:

English

Submitter:

Günter Theodor Michael Seiler

Date Deposited:

26 Feb 2018 15:32

Last Modified:

23 Oct 2019 16:50

Publisher DOI:

10.1167/iovs.17-21559

PubMed ID:

28494493

BORIS DOI:

10.7892/boris.108527

URI:

https://boris.unibe.ch/id/eprint/108527

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