Nonlinear optical crosslinking (NLO CXL) for correcting refractive errors.

Nonlinear optical crosslinking (NLO CXL) for correcting refractive errors.
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DOI:
10.1016/j.exer.2020.108199
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发表时间:
2020-10
影响因子:
3.4
通讯作者:
Jester JV
Jester JV
中科院分区:
医学3区
文献类型:
--
作者:
Bradford S;Mikula E;Juhasz T;Brown DJ;Jester JV

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核黄素(Rf)的基于紫外线A(UVA)光的光活化以诱导角膜交联(CXL)和机械硬化现在是用于角膜扩张和圆锥角膜的众所周知的治疗,其被用于地形引导的光折射基质内CXL(PiXL)手术以治疗低度屈光不正。还提出了非侵入性治疗屈光不正的替代方法,其使用飞秒激光(FS),提供比UVA CXL更快,更精确和更安全的结果。一种这样的治疗,非线性光学交联(NLO CXL),已经能够复制UVA CXL的效果,同时产生更小面积的细胞损伤,并需要更短的手术时间。与UVA CXL不同,NLO CXL的治疗体积仅发生在激光的焦点体积内,可以放置在任何深度并扫描成任何图案,以进行真正的地形引导屈光矫正。这篇综述介绍了我们使用FS激光光激活Rf和执行高度控制的角膜CXL的经验,导致机械硬化和角膜形状的变化。
Ultraviolet A (UVA) light-based photoactivation of riboflavin (Rf) to induce corneal crosslinking (CXL) and mechanical stiffening is now a well-known treatment for corneal ectasia and Keratoconus that is being used in a topographically guided photorefractive intrastromal CXL (PiXL) procedure to treat low degrees of refractive errors. Alternative approaches for non-invasive treatment of refractive errors have also been proposed that use femtosecond lasers (FS) that provide much faster, more precise, and safer results than UVA CXL. One such treatment, nonlinear optical crosslinking (NLO CXL), has been able to replicate the effects of UVA CXL, while producing a smaller area of cellular damage and requiring a shorter procedure time. Unlike UVA CXL, the treatment volume of NLO CXL only occurs within the focal volume of the laser, which can be placed at any depth and scanned into any pattern for true topographically guided refractive correction. This review presents our experience with using FS lasers to photoactivate Rf and perform highly controlled corneal CXL that leads to mechanical stiffening and changes in corneal shape.
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