ArticlePloS one2021
Experimental in-vitro investigation on Epi-Off-Crosslinking on porcine corneas.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Evaluation of the Physiological Corneal Intrastromal Riboflavin Concentration and the Corneal Elastic Modulus After Violet Light Irradiation.Translational vision science & technology · 2021Trial
- Differential dose-response relationships of collagen cross-linking in the cornea and sclera.Frontiers in bioengineering and biotechnology · 2026Article
- Predicting the Effects of Customized Corneal Cross-Linking on Corneal Geometry.Investigative ophthalmology & visual science · 2025Article
- Efficacy and Safety of Accelerated Transepithelial Corneal Crosslinking in Non-Pediatric Patients with Progressive Keratoconus: Insights from a Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2025Article
- Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions.Clinical ophthalmology (Auckland, N.Z.) · 2023Review
- Progressive high-fluence epithelium-on accelerated corneal crosslinking: a novel corneal photodynamic therapy for early progressive keratoconus.Frontiers in medicine · 2023Article
- Optomechanical assessment of photorefractive corneal cross-linking via optical coherence elastography.Frontiers in bioengineering and biotechnology · 2023Article
- Transepithelial Enhanced Fluence Pulsed Light M Accelerated Crosslinking for Early Progressive Keratoconus with Chemically Enhanced Riboflavin Solutions and Air Room Oxygen.Journal of clinical medicine · 2022Article
- Clinical Outcomes of Accelerated Corneal Cross-Linking for Pediatric Keratoconus.Journal of ophthalmology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate quantitatively the effects of the Epi-Off-CXL irradiance dose on the stromal stiffening of pig corneas.
settingLaboratory of Biological structures (LaBS), Politecnico di Milano, Milano, Italy.
methodsInflation tests have been carried on 90 excised and de-epithelized pig corneas, monitoring the change of configuration of the corneal dome at specific pressures. Test have been carried out twice on each cornea, once before and once after Epi-Off-CXL performed at a constant irradiance of 9 mW/cm2 and variable UV-A exposure times. Corneas were grouped according to the exposure time (2.5, 5, 10, 15 and 20 min), proportional to the irradiation dose (1.35, 2.7, 5.4, 8.1, and 10.8 J/cm2). A theoretical model based on linearized shell theory has been used to estimate the increment of the corneal stiffness.
resultsThe linearized shell theory allowed to establish a quantitative relation between the increment of the stiffness parameters and the irradiation dose. Relative to the pre-treatment values, in all experiments the post-treatment corneal stiffness revealed a pronounced increase. In general, the stiffness gain increased with the exposure time. No significant differences in stiffening was observed between tests conducted at 2.5, 5, and 10 min exposure.
conclusionsQualitatively, the effectiveness of accelerated CXL treatments observed in pig corneas complies very well with in-vivo clinical results in humans, suggesting that experimental data in pigs can be very useful for the design of the procedure in humans. A larger irradiation dose provides a larger increment of the corneal stiffness. Due to the biological variability of the tissues, however, it is difficult to distinguish quantitatively the level of the reinforcement induced by accelerated protocols (low doses with < = 10 min exposure), less prone to induce damage in the corneal tissue. Therefore, the definition of personalized treatments must be related to the actual biomechanics of the cornea.
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