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

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...

Full description

Saved in:
Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Ophthalmology Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666914525001149
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:2666-9145