Evidence map›Paper›PMID 40208893›Full record

ArticleTranslational vision science & technology2025

Hyperbaric Oxygenation Increases Available Oxygen and Resistance to Enzymatic Digestion in Accelerated Corneal Collagen Crosslinking.

Johannes Menzel-Severing, Theresa Streit, Jule Schmiedel, Sven Dreyer, Theo G Seiler, Joana Witt, Gerd Geerling

Abstract read
In one paragraph

Article in Translational vision science & technology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Johannes Menzel-SeveringDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Theresa StreitDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Jule SchmiedelDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Sven DreyerDepartment of Orthopedics and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Theo G SeilerDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Joana WittDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.
Gerd GeerlingDepartment of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, NRW, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: The present study aimed to determine whether hyperbaric oxygenation increases intrastromal oxygen concentration during accelerated corneal collagen crosslinking (CXL) and whether this enhances CXL effects. Methods: Oxygen concentration was measured in porcine corneas during epithelium-off CXL with UV-A intensity of 9 mW/cm2 for 10 minutes. Experiments were performed under normobaric and hyperbaric (2.4 bar) conditions, with and without supplemental oxygen. Stromal resistance to lysis by collagenase A and biomechanical changes were measured. Results: Oxygen concentrations before irradiation averaged 11% in the normobaric group (CXLnorm), 37% in the normobaric group with supplemental oxygen (CXLnorm + O2), 13% in the hyperbaric group (CXLhyp), and 43% in the hyperbaric group with supplemental oxygen (CXLhyp + O2). After the onset of UV-A, oxygen concentration decreased to 1.5% in CXLnorm, 3% in CXLhyp, 21% in CXLnorm + O2, and 38% in CXLhyp + O2. Differences between groups were statistically significant (P < 0.0001). Corneal lenticules from the CXLhyp + O2 group were completely digested by collagenase after 5.4 days (standard deviation = 1.34). This was significantly later (P < 0.05) than in other groups. Biomechanical testing did not reveal meaningful differences between the treatment protocols. Conclusions: These data suggest that hyperbaric oxygenation increases intrastromal oxygen in porcine corneas, ensuring constant availability during accelerated CXL. This leads to enhanced resistance to collagenase digestion of anterior corneal stroma. Translational Relevance: More intrastromal oxygen and resistance to proteolytic enzymes may make CXL with hyperbaric oxygenation an improved treatment for progressive keratoconus and (infectious) corneal ulcers.

Indexed as

CollagenCorneaCorneal StromaCross-Linking ReagentsHyperbaric OxygenationOxygenAnimalsCollagenasesPhotosensitizing AgentsRiboflavinSwineUltraviolet RaysCollagenCollagenasesCross-Linking ReagentsOxygenPhotosensitizing AgentsRiboflavin

Identifiers

PMID40208893
PMCPMC11993125

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.