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Collagen Fiber Diameter after Riboflavin/UVA-induced Collagen Cross-linking in the Rabbit Cornea

1Wollensak G., 1Spörl E., 2Seiler T., 1Pillunat L. E.,
1Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Augenheilkunde (Dresden)
2Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Augenheilkunde (Zürich)

Purpose: Mechanical stabilization of the cornea using riboflavin/UVA-induced collagen crosslinking has been applied successfully in keratoconus patients for 4 years. The purpose of the present experimental study was to clarify the influence of crosslinking on the collagen fiber diameter in the cornea.
Methods: Seven albino rabbits were treated with 0.1% riboflavin-5-phosphate (in 20% dextran solution) as photosensitizer and UVA (370 nm, 3 mW/cm²) for 30 min. The left fellow eyes were used as internal controls. The eyes were removed 4 hours postoperatively and fixed in glutaraldehyde. In ultrathin sections the fiber diameter of the corneal collagen fibers was determined morphometrically using an electron microscope.
Results: In the anterior stroma, the collagen fiber diameter was increased significantly (P<0.001) in all treated corneas by on the average 4.34 nm (13.8 %). In the posterior stroma, the collagen fiber diameter of 5 treated corneas was increased significantly(P<0.001) by on the average 2.21 nm (7.1 %).
Conclusions: Collagen crosslinking using riboflavin and UVA leads to a significant increase in corneal collagen fiber diameter. This morphological alteration is the morphological substrat for the increase in biomechanical stability induced by the treatment.