Clinical Efficacy of Ex Vivo Cross-Linking on Neovascularization of the Donor Cornea Carrier Tissue for the Boston Type I Keratoprosthesis

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-05-01 DOI:10.1016/j.xops.2025.100816

Ana M. Roldan MD , Rohan Bir Singh MD , Sofia De Arrigunaga MD , Elizabeth L. Gatto , Alexander Melki , Steven J. Staffa MS , David Zurakowski MS, PhD , Nikolay Boychev OD, PhD, MEd , Joseph B. Ciolino MD , Keratoprosthesis Cross-linking Study Group

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Abstract

Purpose

To evaluate the effect of corneal cross-linking (CXL) on corneal neovascularization (CNV) between eyes that were randomized to receive either CXL or non-CXL donor corneas as the carrier tissue for Boston keratoprosthesis surgery.

Design

A retrospective masked analysis of CNV from slit lamp photographs taken at postoperative weeks 16, 24, 36, and 52.

Subjects

Sixty-eight donor corneas were prospectively randomized 1:1 to receive either donor corneas that underwent ex vivo CXL or were non-CXL. The images of 47 corneas that were suitable for evaluation were included in the final analysis.

Methods

The slit lamp photos were analyzed morphometrically using a standardized protocol on Photoshop CS5 (Adobe Systems Inc) and ImageJ software (National Institutes of Health).

Main Outcome Measures

The 2 primary metrics used to quantify CNV were neovascular area (NA), defined as the area of corneal vessels projected onto the plane of a photograph, and invasion area (IA), defined as the fraction of corneal area in which vessels are present.

Results

Based on multivariable mixed-effects linear modeling, CXL reduces the percentage of NA in the CXL group by 2.2% (P = 0.113). Similarly, there is an average reduction of 7.8% in the percentage of IA in the CXL group compared with the non-CXL group (P = 0.303).

Conclusions

Although not statistically significant, this study observed a trend toward a lower CNV in CXL donor corneas compared with non-CXL donor corneas, suggesting that ex vivo CXL of donor corneas may protect against CNV of the donor cornea.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

体外交联对波士顿I型角膜假体供体角膜载体组织新生血管的临床疗效

目的评价角膜交联（CXL）对角膜新生血管形成（CNV）的影响，这些角膜交联（CXL）是随机选择接受CXL或非CXL供体角膜作为波士顿角膜假体手术的载体组织。设计对术后第16、24、36和52周裂隙灯照片的CNV进行回顾性掩盖分析。68例供体角膜按1:1的比例随机分配，分别接受体外角膜移植和非体外角膜移植。47张适合评价的角膜图像纳入最终分析。方法采用Photoshop CS5 （Adobe Systems Inc .）和ImageJ （National Institutes of Health）软件对裂隙灯照片进行形态计量学分析。用于量化CNV的两个主要指标是新生血管面积（NA），定义为角膜血管投射到照片平面上的面积，以及浸润面积（IA），定义为血管存在的角膜面积的比例。结果基于多变量混合效应线性模型，CXL使CXL组NA百分比降低2.2% （P = 0.113）。同样，与非CXL组相比，CXL组IA百分比平均降低7.8% （P = 0.303）。结论虽然没有统计学意义，但本研究观察到与非CXL供体角膜相比，CXL供体角膜的CNV有降低的趋势，提示体外CXL供体角膜可能对供体角膜的CNV有保护作用。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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