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Title: Corneal remodelling and topography following biological inlay implantation with combined crosslinking in a rabbit model
Authors: Damgaard, Iben Bach
Liu, Yu-Chi
Riau, Andri Kartasasmita
Teo, Ericia Pei Wen
Tey, Min Li
Nyein, Chan Lwin
Mehta, Jodhbir Singh
Keywords: DRNTU::Engineering::Materials
Preclinical Research
Translational Research
Issue Date: 2019
Source: Damgaard, I. B., Liu, Y.-C., Riau, A. K., Teo, E. P. W., Tey, M. L., Nyein, C. L., & Mehta, J. S. (2019). Corneal remodelling and topography following biological inlay implantation with combined crosslinking in a rabbit model. Scientific Reports, 9, 4479-. doi:10.1038/s41598-019-39617-0
Series/Report no.: Scientific Reports
Abstract: Implantation of biological corneal inlays, derived from small incision lenticule extraction, may be a feasible method for surgical management of refractive and corneal diseases. However, the refractive outcome is dependent on stromal remodelling of both the inlay and recipient stroma. This study aimed to investigate the refractive changes and tissue responses following implantation of 2.5-mm biological inlays with or without corneal collagen crosslinking (CXL) in a rabbit model. Prior to implantation, rotational rheometry demonstrated an almost two-fold increase in corneal stiffness after CXL. After implantation, haze gradually subsided in the CXL-treated inlays (p = 0.001), whereas the untreated inlays preserved their clarity (p = 0.75). In-vivo confocal microscopy revealed reduced keratocyte cell count at the interface of the CXL inlays at week 8. Following initial steepening, regression was observed in anterior mean curvature from week 1 to 12, being most prominent for the non-CXL subgroups (non-CXL: −12.3 ± 2.6D vs CXL: −2.3 ± 4.4D at 90 μm depth, p = 0.03; non-CXL: −12.4 ± 8.0D vs CXL: −5.0 ± 4.0D at 120 μm depth, p = 0.22). Immunohistochemical analysis revealed comparable tissue responses in CXL and untreated subgroups. Our findings suggest that CXL of biological inlays may reduce the time before refractive stabilization, but longer postoperative steroid treatment is necessary in order to reduce postoperative haze.
DOI: 10.1038/s41598-019-39617-0
Rights: © 2019 The Author(s) (Nature Publishing Group). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit
Fulltext Permission: open
Fulltext Availability: With Fulltext
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