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First Author: C.O'Donnell UK
Co Author(s): I. Beshtawi R. Akhtar A. Brahma F. Carley C. Hillarby H. Radhakrishnan
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This study was carried out to explore the biomechanical changes induced by repeated cross-linking treatment of human corneal tissue in-vitro, using scanning acoustic microscopy (SAM).
Faculty of Life Sciences, The University of Manchester, Manchester, UK
Methods: Ten human corneal pairs were included in the study, divided into two groups. In group (A), five corneas were treated once with low intensity cross-linking (epithelium removed, 0.1% riboflavin applied for 30 minutes following which UV-A irradiation (365 nm, 3mW/cm2) was applied for 30 minutes along with the riboflavin solution). The contralateral corneas were exposed to riboflavin only, without UV-A exposure, and served as a control. In group (B) five corneas were treated twice, 24 hours apart, with low intensity cross-linking as described above. The contralateral control corneas were treated with riboflavin only. The speed of sound, which is directly proportional to the stiffness of the tissue, was assessed using SAM.
Results: In group (A), the speed of sound of the treated corneas was 1674.51 ±21.38 ms-1 anteriorly and 1598.24 ±27.83 ms-1 posteriorly, while it was 1593.96 ±22.51 ms-1 anteriorly and 1578.64 ±18.83 ms-1 posteriorly in the untreated corneas. The increase in stiffness between the cross-linked and control corneas in the anterior (200 Ṫ 200 ?m) region was by a factor of 1.05. In group (B), the speed of sound of the treated corneas was 1740.29 ±21.39 ms-1 anteriorly and 1626.92 ±20.56 ms-1 posteriorly, while it was 1633.93 ±22.90 ms-1 anteriorly and 1615.88 ±27.98 ms-1 posteriorly in the control corneas. The increase in stiffness between the cross-linked and control corneas in the anterior (200 Ṫ 200 ?m) region was by a factor of 1.07.
Conclusions: Using scanning acoustic microscopy a greater speed of sound was demonstrated in the treated corneas compared with the controls. Furthermore, a greater stiffness increase was found in the repeated treatment group compared with the single treatment group, suggesting that further cross-links are induced when collagen cross-linking is repeated.