Uv Laser Riboflavin Corneal Cross-Linking: Dose–Response Biomechanics And Ocular Safety Versus Led Cxl
Published 2026 - 44th Congress of the ESCRS
Reference: PP16.11 | Type: Free paper | DOI: 10.82333/pyka-wf49
Authors: Tian Lin 1 , Yang Shen* 1 , Xinjie Zhu 1 , Zhixiang Hua 1 , Yueran Xin 2 , Yunlu Sun 2 , Xingtao Zhou 1 , Xiaoying Wang 1
1Eye & ENT Hospital of Fudan University,Shanghai,China, 2Fudan University,Shanghai,China
Purpose
To determine whether riboflavin-assisted ultraviolet laser corneal cross-linking can achieve effective biomechanical strengthening thereby providing a more precise and potentially individualized approach than conventional LED corneal collagen crosslinking (CXL).
Setting
Experimental study of corneal cross-linking using ex vivo porcine eyes. The study included 16 porcine eyes and each group included four eyes.
Methods
Ex vivo porcine corneas underwent riboflavin-assisted ultraviolet laser cross-linking at graded irradiances (15mw/cm2, 6min, 30mw/cm2,10min, 60mw/cm2,10min) to evaluate the dose–response relationship, with conventional LED CXL (5.4J/cm2, 30min), as the reference. Young’s modulus was calculated at prespecified strain level (0%, 2%, 4%, 6%, and 8%), and one-way ANOVA was used to compare biomechanical differences among groups and identify the UV-laser setting with effects closest to LED CXL. This protocol was then applied in vivo rabbits for safety evaluation in the future.
Results
Ex vivo porcine corneal tensile testing showed that Young’s modulus increased from 0% to 8% strain in all groups. Compared with the LED group, the low-dose UVA group (15mw/cm2, 6min) showed no statistically significant difference in instantaneous Young’s modulus across the entire 0–8% strain range. Specifically, at 0% strain, Young’s modulus was 0.24 ± 0.11 MPa in the LED group and 0.34 ± 0.27 MPa in the UVA group (p = 0.531). At 2% strain, the corresponding values were 0.76 ± 0.31 MPa and 0.43 ± 0.14 MPa (p = 0.121). At 4% strain, they were 0.90 ± 0.07 MPa and 0.74 ± 0.11 MPa (p = 0.057). At 6% strain, they were 1.22 ± 0.59 MPa and 0.92 ± 0.35 MPa (p = 0.423). At 8% strain, they were 1.98 ± 1.25 MPa and 1.31 ± 0.63 MPa (p = 0.388).
Conclusions
UV-laser riboflavin corneal cross-linking provides controllable, dose-dependent biomechanical stiffening. A low-dose protocol produced biomechanics most comparable to standard LED CXL in an ex vivo model. These findings support further development of programmable UV-laser CXL to achieve cross-linking.