Open AccessDepth-resolved Corneal Biomechanical Changes Measured Via Optical Coherence Elastography Following Corneal Crosslinking
Author(s) -
Tanner J. Ferguson,
Srinidhi Singuri,
Sanjai Jalaj,
Matthew R. Ford,
Vinícius Silbiger De Stefano,
Ibrahim Seven,
William J. Dupps
Publication year - 2021
Publication title -
translational vision science and technology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.508
H-Index - 21
ISSN - 2164-2591
DOI - 10.1167/tvst.10.5.7
Subject(s) - optical coherence tomography , keratoconus , cornea , ophthalmology , medicine , lasik , corneal collagen cross linking , ectasia , elastography , biomedical engineering , scheimpflug principle , optics , materials science , surgery , ultrasound , physics , radiology
Purpose To evaluate depth-resolved changes of corneal biomechanical properties in eyes with corneal ectasia after corneal crosslinking (CXL) using optical coherence elastography. Methods In a prospective pilot series of eyes with corneal ectasia, a custom high-speed swept source optical coherence tomography system was used to image the cornea before and 3 months after CXL during a low-speed applanating deformation while monitoring applanation force. Cross-correlation was applied to track frame-by-frame two-dimensional optical coherence tomography speckle displacements, and the slope of force versus local axial displacement behavior during the deformation was used to produce a two-dimensional array of axial stiffness ( k ). These values were averaged for anterior ( k a ) and posterior ( k p ) stromal regions and expressed as a ratio ( k a /k p ) to assess depth-dependent differences in stiffness. CXL was performed according to the Dresden protocol with a system approved by the U.S. Food and Drug Administration. Results Four eyes from four patients with keratoconus ( n = 3) or post-LASIK ectasia ( n = 1) underwent optical coherence elastography before and 3 months after CXL. The mean k a /k p was 1.03 ± 0.07 before CXL compared with 1.34 ± 0.17 after the CXL procedure. All four eyes demonstrated at least a 20% increase in the k a /k p .Conclusions Preferential stiffening of the anterior stroma with the standard CXL protocol was demonstrated with optical coherence elastography in live human subjects. Translational Relevance Although ex vivo studies have demonstrated anterior stiffening effects after CXL using various destructive and nondestructive methods, this report presents the first evidence of such changes in serial live human measurements.