Riboflavin-UV crosslinking of the cornea: Wound healing and biomechanics

IF 3 2区医学 Q1 OPHTHALMOLOGY

Experimental eye research Pub Date : 2025-03-05 DOI:10.1016/j.exer.2025.110321

Brecken Blackburn , Barbara A.L. Dutra , Bassel Hammoud , Giuliano Scarcelli , William J. Dupps , J.Bradley Randleman , Steven E. Wilson

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引用次数: 0

Abstract

The corneal wound healing response to Riboflavin-ultraviolet-crosslinking (RIB-UV-CXL) depends on the specific method used in treatment. The predominance of clinical evidence supports the classical “epithelium-off” RIB-UV-CXL method being more effective in halting ectasia progression than various “epithelium-on” methods, where the corneal epithelium is maintained intact. Corneal transparency results from the precise organization of collagen fibrils and extracellular matrix, along with transparent keratocytes. The mild and transient stromal opacity seen after standard RIB-UV-CXL is linked to changes in hydration, cellularity, and matrix composition. As hydration normalizes, opacity arises from the development of corneal fibroblasts and their secretion of disordered extracellular matrix materials including collagens. Over months, as the epithelial basement membrane regenerates, transitioning stromal cells either undergo apoptosis or revert to keratocan-positive keratocytes, restoring stromal transparency. In normal healing after standard RIB-UV-CXL, the stroma is eventually repopulated predominantly by keratocytes without significant persisting fibroblasts, immune cells, or myofibroblasts. Biomechanical studies have extensively explored how CXL strengthens corneal tissue, providing insight into its therapeutic mechanisms. The purpose of this review is to evaluate the wound healing response and biomechanical changes in the cornea following RIB-UV-CXL.

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来源期刊

Experimental eye research 医学-眼科学

CiteScore

6.80

自引率

5.90%

发文量

323

审稿时长

66 days

期刊介绍： The primary goal of Experimental Eye Research is to publish original research papers on all aspects of experimental biology of the eye and ocular tissues that seek to define the mechanisms of normal function and/or disease. Studies of ocular tissues that encompass the disciplines of cell biology, developmental biology, genetics, molecular biology, physiology, biochemistry, biophysics, immunology or microbiology are most welcomed. Manuscripts that are purely clinical or in a surgical area of ophthalmology are not appropriate for submission to Experimental Eye Research and if received will be returned without review.