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The increase in biomechanical stiffness in corneal collagen cross-linking (CXL) is oxygen dependent

Session Details

Session Title: Corneal biomechanics

Session Date/Time: Tuesday 08/10/2013 | 08:00-10:30

Paper Time: 10:06

Venue: Elicium 1 (First Floor)

First Author: : A.Hammer SWITZERLAND

Co Author(s): :    O. Richoz   D. Tabibian   F. Hafezi        

Abstract Details


Recently, corneal collagen cross-linking (CXL) devices have implemented increased UV-A fluence and decreased irradiation times. While the total energy is maintained, oxygen diffusion might become a limiting factor in high-fluence treatment. Here, we investigated the potential oxygen-dependency of CXL.


Ex-vivo experimental study. Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland


We cross-linked two groups (n=16 each) of fresh porcine corneas with a fluence of 9 mW/cm2 for 10 minutes in two different environments, one containing 21 % of oxygen and the other containing less than 1 % of oxygen.


We observed a statistically significant difference (p=0.004) in the increase in biomechanical stiffness measured between the normal oxygen environment and the low-oxygen-environment group.


The biomechanical effect of CXL seems to be an oxygen-dependent process, rising concerns about the efficiency of high fluence CXL and probably also about epithelium-on procedures.

Financial Interest:


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