Precision Microneedle-Enhanced Riboflavin Delivery For Customized Corneal Cross-Linking In Keratoconus Therapy

Purpose: This study is to develop a customized CXL treatment for keratoconus, utilizing microneedles to precisely deliver riboflavin directly into the cornea, thereby improving the precision and efficacy of the treatment compared to conventional methods.

A prospective setting.

Methods: The study encompassed crafting of four unique microneedle mold, namely circular, semi-circular, annular, and butterfly-shaped. These molds served as templates for fabricating microneedle arrays that were preloaded with an optimized solution of riboflavin and hyaluronic acid. The microneedles were subsequently employed to gently penetrate the corneal epithelium while preserving the integrity of the underlying stromal layer. Following the application of the microneedles, the riboflavin (RF) solution was replenished to augment the RF concentration within the stroma, leveraging the punctures created by the microneedles. Microneedles were applied to A-CXL and efficacy was evaluated compared with conventional RF A-CXL protocol.

Results: The application of the customized microneedles led to a notable flattening of the corneal curvature in the treated zone. Replenishing the RF solution enhanced the stromal riboflavin content, which is crucial for effective cross-linking. Moreover, the treatment facilitated a swift postoperative recovery of corneal tissue, demonstrating the potential to reduce healing durations. Importantly, the customized corneal cross-linking effects proved to be comparable to those achieved through the conventional epi-off CXL protocol.

Conclusions: The integration of customized microneedle riboflavin delivery with CXL presents an innovative treatment modality for keratoconus. This approach offers a more precise and efficient alternative to conventional methods, affording the possibility to customize treatments according to individual patient requirements.