Assessment of a Novel Corneal-Shaping Device With Simultaneous Corneal Collagen Cross-Linking Using a Porcine Eye Model

Abstract

Corneal collagen cross-linking (CXL) alone cannot substantially improve refractive errors. We designed a novel corneal-shaping device, showing that a prototype applied during CXL can alter corneal curvature to a greater extent than CXL alone in a porcine eye model. The device prototype was made with flat, UV-transmissible material. Enucleated porcine eyes were deepithelialized and perfused. Preexperimental and postexperimental corneal curvature (K) measurements and Anterior Segment Optical Coherence Tomography imaging were performed. A conventional CXL protocol was followed. Six experiments of 6 treatment groups in duplicate were performed (n = 12/group): (A) no CXL + no device, (B) no CXL + 30 minutes device, (C) 10 minutes, CXL + no device, (D) 10 minutes, CXL + device, (E) 30 minutes, CXL + no device, and (F) 30 minutes, CXL + device. There was a significant decrease (P < 0.001) in corneal curvature after 30 minutes. CXL between group F (-1.54 ± 0.90 D) and groups E (+0.34 ± 0.53 D), B (+0.69 ± 1.02 D), or A (+0.22 ± 1.24 D). The demarcation line depth was greater in group F (34% ± 4%) than group D (30% ± 4%, P < 0.05). Groups D (-2.3% ± 21%) and F (0.24% ± 15%) had less change in corneal thickness than in control groups A (15% ± 12%, P < 0.05) and E (12% ± 11%, P < 0.05). Application of our corneal-shaping device during CXL significantly decreased corneal curvature compared with controls. Anterior Segment Optical Coherence Tomography imaging showed comparable extent of cross-linking in eyes treated ± device. This demonstrates that our novel device used during CXL may further promote corneal strengthening and refractive correction in patients.