Oxygen kinetics during corneal crosslinking with and without supplementary oxygen.

PURPOSE

To measure and simulate oxygen kinetics during corneal crosslinking (CXL) at different irradiances with and without supplementary oxygen.

DESIGN

Experimental, laboratory study.

METHODS

In de-epithelialized porcine eyes, a femtosecond-laser generated tunnel was used to place a fiber-probe in corneal depths of 100, 200 and 300μm to measure the local oxygen concentration. After riboflavin imbibition, the corneas were irradiated at 3, 9, 18 and 30mW/cm2 while the oxygen concentration was measured. All experiments were performed under normoxic (21%) and hyperoxic (>95%) conditions. The obtained data were used to identify parameters of a numerical model for oxygen consumption and diffusion.

RESULTS

The equilibrium stromal oxygen concentration under atmospheric oxygen at 3mW/cm2 was 2.3% in 100μm decreasing to <1% in 300μm. With 9, 18 and 30mW/cm2, no oxygen was available in 200μm respectively 100μm or deeper. Using a hyperoxic environment, the concentration was 50% using 3mW/cm2 in 100μm, decreasing to 40% in 300μm. At 9mW/cm2 the concentrations were 5%, 3% and 1% in 100, 200 and 300μm, respectively. Using 18 and 30mW/cm2 all oxygen was depleted at 100μm, however, oxygen half-lives were longer at 18mW/cm2 than at 30mW/cm2. The oxygen model was able to reproduce the experiments and indicated an exponential decay with increasing distance to the anterior surface.

CONCLUSION

Supplementary oxygen increases the oxygen-availability during CXL. At higher irradiances, supplementary oxygen is beneficial and eliminates the bottleneck of oxygen allowing a potentially more efficient crosslinking. The calibrated numerical model can quantify the spatial oxygen concentration related to different scenarios such as irradiance or environmental oxygen concentration.