Department of Anatomy, University of Otago, Dunedin, New Zealand.
Ophthalmology Section, Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Clin Anat. 2021 Sep;34(6):859-866. doi: 10.1002/ca.23728. Epub 2021 Feb 23.
Corneal crosslinking (CXL) has revolutionized the treatment of keratoconus during the past decade. In the present study, the morphological changes in the corneal collagen fibrils (CFs) following crosslinking treatment are described.
Ten pairs of porcine and rabbit corneas were retrieved. In each pair, one cornea was the control and the other underwent CXL treatment. The central corneal thickness (CCT) was measured before and after CXL treatment. Each treated and control cornea was examined with light microscopy and by transmission electron microscopy.
(a) The mean CCT was significantly reduced following treatment. (b) CFs were more closely packed in the anterior region and loosely packed in the posterior region. (c) CF diameter increased significantly in the anterior and intermediate regions but declined gradually towards the deeper regions. (d) There was a statistically significant decrease in the interfibrillar distance over the different regions of the cornea, except for the posterior region in porcine corneas, where there was no change. (e) The distance between adjacent collagen lamellae was significantly decreased in all regions of treated rabbit corneas. There was no change in porcine corneas.
CXL treatment resulted in increased the CF diameter and decreased interfibrillar distance in the anterior and intermediate regions, while its effects on the posterior region differed among species. The effect on interlamellar distance was more prominent in the rabbit model than the porcine model. CXL treatment stiffened the corneas by increasing CF diameter and decreasing interfibrillar distance in both rabbit and pig corneas.
在过去的十年中，角膜交联（CXL）技术的出现彻底改变了角膜圆锥角膜的治疗方法。本研究描述了交联治疗后角膜胶原纤维（CF）的形态变化。
收集了十对猪和兔眼角膜。每对眼角膜中，一只作为对照，另一只接受 CXL 治疗。治疗前后测量中央角膜厚度（CCT）。用光学显微镜和透射电子显微镜检查每只处理和对照角膜。
（a）治疗后平均 CCT 显著降低。（b）CF 在角膜前区排列更紧密，后区排列更疏松。（c）CF 直径在前部和中间部显著增加，但在较深部逐渐减少。（d）除猪眼角膜后区外，角膜不同区域的纤维间距离均有统计学意义的减少，但无变化。（e）所有处理兔眼角膜的区域中，相邻胶原板层之间的距离显著减小，而猪眼角膜无变化。
CXL 治疗导致角膜前区和中间区 CF 直径增加，纤维间距离减小，而对后区的影响在不同物种间存在差异。兔模型中板层间距离的变化比猪模型更明显。CXL 治疗通过增加 CF 直径和减少纤维间距离，使兔和猪眼角膜变硬。
