Influence of Microstructure on Stiffening Effects of Corneal Cross-linking Treatment.

Purpose: To investigate the stiffening effects of corneal cross-linking (CXL) on tensile properties of anterior and posterior corneal flaps.

Methods: A Descemet stripping automated endothelial keratoplasty system was used to prepare anterior and posterior flaps from porcine corneas. The flaps were subjected to CXL and their mechanical behavior was assessed by conducting uniaxial tensile experiments. Full-thickness corneas were also cross-linked from the posterior and anterior side and their tensile behavior was measured.

Results: The CXL procedure significantly improved biomechanical properties of anterior flaps (P < .05). CXL did not have any significant effect on tensile properties of posterior flaps. Cross-linking full-thickness porcine corneal stroma from the posterior side had no significant stiffening effect.

Conclusions: The stiffening effect of CXL therapy depends significantly on the composition and microstructure of corneal extracellular matrix. [J Refract Surg. 2018;34(9):622-627.].