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The effect of pulsed cross-linking on corneal biomechanics

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Session Details

Session Title: Cross-Linking

Session Date/Time: Sunday 06/09/2015 | 08:00-09:30

Paper Time: 08:18

Venue: Main Auditorium

First Author: : S.Kling SWITZERLAND

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

Abstract Details


Pulsed UV irradiation aims at overcoming insufficient tissue oxygenation during accelerated corneal cross-linking (CXL). In this study we compare the biomechanical effect of different pulsed and standard continuous CXL protocols.


Laboratory for Ocular Cell Biology, University of Geneva, Rue Michel Servet 1, 1206 Geneva, Switzerland


25 freshly enucleated porcine eyes were divided into 5 groups. Corneas were de-epithelialized and riboflavin was instilled for 30 minutes, prior to UV-irradiation: Group I received 30 mW/cm2 in 1s-on 1s-off intervals during 8 minutes. Group II received 100 mW/cm2 in 10ms-on 990ms-off during 11 minutes. Group III received 9 mW/cm2 continuously during 10 minutes. Group IV received 3 mW/cm2 continuously during 30 minutes. Group V was not irradiated and served as control. Corneas were cut into 2 strips and subjected to pre-conditioning, stress-relaxation at 0.6 MPa and stress-strain testing up to 5.7 MPa.


From stress-relaxation tests, pulsed and accelerated CXL (groups I-III) showed with 402±24 kPa a significantly decreased (p≤0.006) resistance to stress, compared to 441±19 kPa in the standard CXL protocol (group IV), but a significantly increased resistance (p≤0.017) to stress compared to 364±20 kPa in the control (group V). No significant differences (p≥0.732) were observed within pulsed CXL protocols (398±34 vs 402±34 kPa), or between pulsed and accelerated CXL protocols (400±34 vs 397±25 kPa).


Our results indicate that pulsed CXL and continuous accelerated CXL had the same effect, but were both inferior to standard CXL.

Financial Interest:


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