Advanced Cross-Linking Techniques: Epi-On and Customized Protocols with Supplemental Oxygen

Gustavo Tomayo1, Miltos Balidis2, Rajesh Rajpal3,4, and Desmond C. Adler4

1 Bogota Laser Refractive Institute, Bogota, Columbia
2 Ophthalmica Vas. Olgas, Thessaloniki, Greece  
3 See Clearly Vision Group, McLean VA, USA
4 Glaukos Corp, Waltham MA, USA

World Ophthalmology Congress (WOC) Virtual
26 – 29 Ιουνίου 2020
https://icowoc.org/

Objectives

Cross-Linking with Supplemental Oxygen

Corneal collagen cross-linking photochemistry is strongly dependent on stromal oxygen levels in combination with UV delivery parameters and photosensitizer formulation. Stromal oxygen can be modulated by providing oxygen gas around the ocular surface. This laboratory study aimed to evaluate a series of normoxic and hyperoxic epi-on cross-linking protocols that have recently been translated into clinical use by:

1.Invasive measurement of stromal oxygen concentrations before, during, and after UV irradiation
2.Analysis of induced acute anterior surface flattening via Scheimpflug tomography and bulk material stiffening via biaxial extensiometry
3.Comparison of all results to positive (epi-off Dresden protocol) and negative (no cross-linking) control samples

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