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Confocal microscopy evaluation of stromal fluorescence intensity after standard and iontophoresis corneal cross-linking

Poster Details

First Author: M.Lanzini ITALY

Co Author(s):    C. Curcio   R. Calienno   M. Colasante   E. Spoerl   R. Turilli   L. Mastropasqua     

Abstract Details


Aim of this study is to determine differences in stromal riboflavin fluorescence intensity after iontophoresis imbibition and different exposure to UVA sources or standard epi-off procedures in human cadaver corneas and to correlate stromal fluorescence intensity to corneal biomechanical resistance.


Ophthalmic Clinic. G d'Annunzio University. Chieti-Pescara. Italy


For confocal microscopy study 15 human cadaver corneas were examined. 3 served as control(group 1), 3 were soaked with iontophoresis procedure(group 2), 3 were treated with standard technique(group 3), 6 underwent iontophoresis imbibition and 3 were irradiated for 30 minutes with 3 mW/cm2 UVA(group 4) and 3 for 9 minutes at 10 mW/cm2 UVA(group 5). Confocal microscopy was performed to quantify the fluorescence intensity in the cornea at different stromal depth. For biomechanical study 30 human cadaver corneas were randomly divided in 5 groups and treated as previously described. Static stress-strain measurements of the corneas were performed.


Iontophoresis imbibition followed by 10mW/cm2 irradiation proved to increase stromal fluorescence into the cornea and significant difference were revealed between group 3 and 5 both at 100 (p=0.0171) and 250 µm (p=0.0024) of stromal depth. Biomechanical analysis showed an improvement of corneal resistance in tissues treated with iontophoresis imbibition and accelerated irradiation (10mW/cm²).


Iontophoresis imbibition followed by accelerated UVA irradiation for 9 minutes at 10mW/cm2 increased the stromal fluorescence despite the presence of an intact epithelium and is related to an improvement of biomechanical resistance. This approach may represent a new strategy to achieve greater concentrations of riboflavin without removing corneal epithelium and improve clinical results while reducing the side effects of corneal cross-linking.

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