A study of corneal structure and biomechanical properties after collagen crosslinking with genipin in rabbit corneas.

Purpose: Aim to assess the short-term effect of genipin collagen crosslinking (G-CXL) on corneal structure and biomechanical properties compared with ultraviolet A/riboflavin collagen crosslinking (UVA-CXL) in rabbit corneas. Methods: Right eyes of 40 healthy rabbits were divided into the 0.20% G-CXL group, 0.25% G-CXL group, UVA-CXL group, and control group. Anterior segment optical coherence tomography (ASOCT) and in vivo confocal microscopy (IVCM) were performed before, 7 days after, and 14 days after the CXL treatment. Corneal strips were harvested for tensile strain measurements 7 and 14 days after the CXL treatment. Results: ASOCT showed the demarcation line (DL) in the UVA-CXL group was deeper than in the 0.20% G-CXL group and the 0.25% G-CXL group on day 7 (p=0.014) and day 14 (p=0.012). Nerve and keratocyte density in all CXL groups decreased, but was more obvious in the UVA-CXL group (p<0.001). Endothelial cell loss in the 0.20% G-CXL group, 0.25% G-CXL group, UVA-CXL group, and control group was 11.7%, 6.8%, 32.8%, and 2.0% 14 days after CXL, respectively. Young's modulus and stress in the 0.25% G-CXL group and the UVA-CXL group were statistically significantly higher than in the control group (p<0.05) 7 and 14 days after CXL. No statistically significant differences were observed between the 0.25% G-CXL group and the UVA-CXL group (p>0.05). The DL depth was positively correlated with Young's modulus (r=0.426, p=0.042) and stress (r=0.469, p=0.024). Conclusions: The administration of 0.25% genipin enhances corneal biomechanical properties as long as 14 days after the CXL treatment with low toxicity. The DL exists in CXL-treated corneas, and the depth is related to the biomechanical properties.