School of Aeronautics, Northwestern Polytechnical University, Xi'an, China.
National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Invest Ophthalmol Vis Sci. 2023 Oct 3;64(13):26. doi: 10.1167/iovs.64.13.26.
To evaluate the regional effects of different corneal cross-linking (CXL) protocols on corneal biomechanical properties.
The study involved both eyes of 50 rabbits, and the left eyes were randomized to the five intervention groups, which included the standard CXL group (SCXL), which was exposed to 3-mW/cm2 irradiation, and three accelerated CXL groups (ACXL1-3), which were exposed to ultraviolet-A at irradiations of 9 mW/cm2, 18 mW/cm2, and 30 mW/cm2, respectively, but with the same total dose (5.4 J/cm2). A control (CO) group was not exposed to ultraviolet-A. No surgery was done on the contralateral eyes. The corneas of each group were evaluated by the effective elastic modulus (Eeff) and the hydraulic conductivity (K) within a 7.5-mm radius using nanoindentation measurements.
Compared with the CO group, Eeff (in regions with radii of 0-1.5 mm, 1.5-3.0 mm, and 3.0-4.5 mm) significantly increased by 309%, 276%, and 226%, respectively, with SCXL; by 222%, 209%, and 173%, respectively, with ACXL1; by 111%, 109%, and 94%, respectively, with ACXL2; and by 59%, 41%, and 37%, respectively, with ACXL3 (all P < 0.05). K was also significantly reduced by 84%, 81%, and 78%, respectively, with SCXL; by 75%, 74%, and 70%, respectively, with ACXL1; by 64%, 62%, and 61%, respectively, with ACXL2; and by 33%, 36%, and 32%, respectively, with ACXL3 (all P < 0.05). For the other regions(with radii between 4.5 and 7.5 mm), the SCXL and ACXL1 groups (but not the ACXL2 and ACXL3 groups) still showed significant changes in Eeff and K.
CXL had a significant effect on corneal biomechanics in both standard and accelerated procedures that may go beyond the irradiated area. The effect of CXL in stiffening the tissue and reducing permeability consistently decreased with reducing the irradiance duration.
评估不同角膜交联（CXL）方案对角膜生物力学特性的区域影响。
本研究纳入了 50 只兔子的双眼，将左眼随机分为 5 个干预组，包括标准 CXL 组（SCXL），其接受 3 mW/cm2 的照射，以及 3 个加速 CXL 组（ACXL1-3），其分别接受紫外线 A 照射强度为 9 mW/cm2、18 mW/cm2 和 30 mW/cm2，但总剂量相同（5.4 J/cm2）。对照组（CO）未接受紫外线 A 照射。对右眼不进行任何手术。通过纳米压痕测量，在半径为 7.5mm 的范围内评估各组角膜的有效弹性模量（Eeff）和水力传导率（K）。
与 CO 组相比，SCXL 组 Eeff（半径为 0-1.5mm、1.5-3.0mm 和 3.0-4.5mm 区域）分别显著增加 309%、276%和 226%；ACXL1 组分别增加 222%、209%和 173%；ACXL2 组分别增加 111%、109%和 94%；ACXL3 组分别增加 59%、41%和 37%（均 P<0.05）。K 也分别显著降低 84%、81%和 78%（SCXL 组）；75%、74%和 70%（ACXL1 组）；64%、62%和 61%（ACXL2 组）；33%、36%和 32%（ACXL3 组）（均 P<0.05）。对于其他区域（半径为 4.5-7.5mm），SCXL 和 ACXL1 组（但不是 ACXL2 和 ACXL3 组）的 Eeff 和 K 仍有显著变化。
CXL 对标准和加速程序的角膜生物力学均有显著影响，这种影响可能超出了照射区域。CXL 组织变硬和通透性降低的效果与降低辐照时间一致。
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