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Critical Reviews™ in Biomedical Engineering
SJR: 0.207 SNIP: 0.376 CiteScore™: 0.79

ISSN 印刷: 0278-940X
ISSN オンライン: 1943-619X

Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.2014011715
pages 229-248

Corneal Cross-Linking: Engineering a Predictable Model

R. Glenn Hepfer
CU-MUSC Bioengineering Program, Department of Bioengineering, Clemson University (CU), Charleston, SC
Changcheng Shi
CU-MUSC Bioengineering Program, Department of Bioengineering, Clemson University (CU), Charleston, SC;
Yongren Wu
CU-MUSC Bioengineering Program, Department of Bioengineering, Clemson University (CU), Charleston, SC
George O. Waring IV
2Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina (MUSC), Charleston, SC
Hai Yao
Bioengineering Department of Bioengineering Clemson University Charleston, SC 29425

要約

Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) light has become a viable treatment for keratoconus. In cases in which corneal transplant may have previously been a patient's primary treatment option, the results of CXL have varied from decreased progression of the disease to marked regression characterized by improvement in visual acuity. In addition, changes to the original protocol have been tested that include leaving the epithelium intact and increasing the UVA intensity while decreasing the exposure time. The variation in results and protocols underscores the need for a greater understanding of the procedure and its effects. Ideally, a complete definition of the effects of CXL will lead to patient-specific treatment through highly controlled delivery methods of riboflavin and UVA light and complete mathematical models for predicting the final shape and refractive effect of the cornea. Thus, in this review, we aimed to describe the current techniques for measuring the effect of CXL, with a focus on material property changes, while highlighting the challenge of engineering a predictable mathematical model of the procedure and the resulting clinical outcome.


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