Comparative study between reticulating agents for possible application in the treatment of keratoconus

ABSTRACT With the present study, we aimed to compare the standard technique of CXL with the treatment using genipine as a crosslinker, with and without corneal de-epithelialization. The chemical, mechanical and morphological properties of pig corneas submitted to crosslinking treatments with riboflavin and genipine were compared, as well as to compare the cytotoxicity of the crosslinking solutions for possible application in keratoconus. The corneas were divided into four groups: riboflavin and UVA according to standard treatment,genipina with epithelium off, genipina with epithelium on and control without crosslinker. In this way, the corneas were submitted to the characterizations and analyzed by the following techniques: OM, SEM, traction test, dilatometry and swelling. The cytotoxicity analysis was performed comparing the standard treatment with genipine. The results demonstrate a greater tensile strength, as well as more swelling when genipine was applied to the epithelium off corneal surface. The downward slopes in the dilatometry curve are linear in the UV-CXL and control, and with genipine, the contraction tends to become more pronounced at higher temperatures. By MEV was able to demonstrate a dmarcation line in the corneal stroma treated with UV-CXL or genipine and OM exhibits different patterns of transmitted light in the different groups, demonstrating greater UV-CXL opacity. The corneal collagen crosslinking induced by 0.1% genipine produces an increase in corneal resistance without causing considerable corneal opacity and may be useful in the treatment of keratoconus. The potential for cytotoxicity to fibroblasts was similar between crosslinking methods.