Experimental evaluation of stiffening effect induced by UVA/Riboflavin corneal cross-linking using intact porcine eye globes

Chang, Shao-Hsuan, Zhou, Dong, Eliasy, Ashkan ORCID: 0000-0002-4473-1900, Li, Yi-Chen and Elsheikh, Ahmed ORCID: 0000-0001-7456-1749
(2020) Experimental evaluation of stiffening effect induced by UVA/Riboflavin corneal cross-linking using intact porcine eye globes. PLOS ONE, 15 (11). e0240724-.

[img] Text
Chang - Stiffening effect of CXL on porcine eyes 2020 final.pdf - Author Accepted Manuscript

Download (2MB) | Preview


UVA/riboflavin corneal cross-linking (CXL) is a common used approach to treat progressive keratoconus. This study aims to investigate the alteration of corneal stiffness following CXL by mimicking the inflation of the eye under the in vivo loading conditions. Seven paired porcine eye globes were involved in the inflation test to examine the corneal behaviour. Cornea-only model was constructed using the finite element method, without considering the deformation contribution from sclera and limbus. Inverse analysis was conducted to calibrate the non-linear material behaviours in order to reproduce the inflation test. The corneal stress and strain values were then extracted from the finite element models and tangent modulus was calculated under stress level at 0.03 MPa. UVA/riboflavin cross-linked corneas displayed a significant increase in the material stiffness. At the IOP of 27.25 mmHg, the average displacements of corneal apex were 307 ± 65 μm and 437 ± 63 μm (p = 0.02) in CXL and PBS corneas, respectively. Comparisons performed on tangent modulus ratios at a stress of 0.03 MPa, the tangent modulus measured in the corneas treated with the CXL was 2.48 ± 0.69, with a 43±24% increase comparing to its PBS control. The data supported that corneal material properties can be well-described using this inflation methods following CXL. The inflation test is valuable for investigating the mechanical response of the intact human cornea within physiological IOP ranges, providing benchmarks against which the numerical developments can be translated to clinic.

Item Type: Article
Uncontrolled Keywords: Cornea, Animals, Swine, Humans, Keratoconus, Disease Models, Animal, Riboflavin, Cross-Linking Reagents, Refraction, Ocular, Ultraviolet Therapy, Ultraviolet Rays, Intraocular Pressure, Algorithms, Biomechanical Phenomena
Depositing User: Symplectic Admin
Date Deposited: 05 Oct 2020 07:21
Last Modified: 18 Jan 2023 23:30
DOI: 10.1371/journal.pone.0240724
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3103628