Optomechanical assessment of photorefractive corneal cross-linking via optical coherence elastography.

Frigelli, Matteo; Büchler, Philippe; Kling, Sabine (2023). Optomechanical assessment of photorefractive corneal cross-linking via optical coherence elastography. Frontiers in Bioengineering and Biotechnology, 11, p. 1272097. Frontiers Media 10.3389/fbioe.2023.1272097

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Purpose: Corneal cross-linking (CXL) has recently been used with promising results to positively affect corneal refractive power in the treatment of hyperopia and mild myopia. However, understanding and predicting the optomechanical changes induced by this procedure are challenging. Methods: We applied ambient pressure modulation based optical coherence elastography (OCE) to quantify the refractive and mechanical effects of patterned CXL and their relationship to energy delivered during the treatment on porcine corneas. Three different patterned treatments were performed, designed according to Zernike polynomial functions (circle, astigmatism, coma). In addition, three different irradiation protocols were analyzed: standard Dresden CXL (fluence of 5.4 J/cm2), accelerated CXL (fluence of 5.4 J/cm2), and high-fluence CXL (fluence of 16.2 J/cm2). The axial strain distribution in the stroma induced by ocular inflation (Δp = 30 mmHg) was quantified, maps of the anterior sagittal curvature were constructed and cylindrical refraction was assessed. Results: Thirty minutes after CXL, there was a statistically significant increase in axial strain amplitude (p < 0.050) and a reduction in sagittal curvature (p < 0.050) in the regions treated with all irradiation patterns compared to the non-irradiated ones. Thirty-6 hours later, the non-irradiated regions showed compressive strains, while the axial strain in the CXL-treated regions was close to zero, and the reduction in sagittal curvature observed 30 minutes after the treatment was maintained. The Dresden CXL and accelerated CXL produced comparable amounts of stiffening and refractive changes (p = 0.856), while high-fluence CXL produced the strongest response in terms of axial strain (6.9‰ ± 1.9‰) and refractive correction (3.4 ± 0.9 D). Tripling the energy administered during CXL resulted in a 2.4-fold increase in the resulting refractive correction. Conclusion: OCE showed that refractive changes and alterations in corneal biomechanics are directly related. A patient-specific selection of both, the administered UV fluence and the irradiation pattern during CXL is promising to allow customized photorefractive corrections in the future.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - AI in Medical Imaging Laboratory
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Computational Bioengineering
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

UniBE Contributor:

Frigelli, Matteo, Büchler, Philippe, Kling, Sabine

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

2296-4185

Publisher:

Frontiers Media

Language:

English

Submitter:

Pubmed Import

Date Deposited:

04 Dec 2023 10:24

Last Modified:

26 Jun 2024 15:23

Publisher DOI:

10.3389/fbioe.2023.1272097

PubMed ID:

38026898

Uncontrolled Keywords:

accelerated CXL ambient pressure modulation corneal biomechanics. (Min.5-Max. 8 corneal cross-linking optical coherence elastography optomechanical changes

BORIS DOI:

10.48350/189621

URI:

https://boris.unibe.ch/id/eprint/189621

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