Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Transepithelial high-fluence CXL in femto-assisted SMILE-like procedure: an ex-vivo biomechanical evaluation

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Session Details

Session Title: Presented Poster Session: Corneal Biomechanics

Session Date/Time: Saturday 10/09/2016 | 15:00-16:30

Paper Time: 15:00

Venue: Poster Village: Pod 4

First Author: : I.Kontari GREECE

Co Author(s): :    A. Kanellopoulos              

Abstract Details


To evaluate feasibility of ex-vivo femto-second laser-assisted intra-lamellar refractive lens extraction (ReLeX) simulation using a novel technique with an alternative femtosecond-laser and investigate effects of in-situ cross-linking.


The Clinical and Research Institute, Athens, Greece


Eight human donor corneas were subjected to intrastromal lamellar corneal tissue removal of anterior 140 μm, 80-μm thick× 5-mm diameter central stromal button, extracted through a 3.5-mm width tunnel, surfacing in the superior cornea periphery. Enhanced concentration riboflavin solution (0.25%) was instilled in the pocket. In the study group-A (CXL), superficial high-fluence UV-A irradiation was applied, while in the control group-B (no CXL), none. To comparatively assess changes in corneal rigidity the corneal specimens were subjected to transverse biaxial resistance measurements by application of unidirectional tangential shear force. Biomechanical differences were evaluated via stress and Young’s shear modulus.


Stress at the 10% strain was 305±24 kPa in the study group-A, versus 157±11 kPa in the control group-B (relative difference Δ=107%, p=0.021). Stress at the 20% strain was 1,284±34 kPa in the study group-A, versus 874±29 kPa in the control group-B (Δ=47%, p=0.043). Average shear modulus in the study group-A at the 10% strain was 6.98±1.12 MPa, versus 4.04±0.85 MPa in the control group-B (Δ=73%, p=0.036). Average shear modulus in the study group-A at the 20% strain was 11.46±0.75 MPa, versus 8.80±0.72 MPa in the group-B (Δ=30%, p=0.047).


Adjunct CXL in this ex-vivo simulation refractive lens extraction procedure appears to provide significant increase in corneal rigidity, up to +107%. These findings also support our previous reported work on LASIK combined with CXL.

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