Establishing Quantitative Functional Metrics to Evaluate the Efficacy of Corneal Crosslinking (CXL) Therapeutic Procedures

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Keratoconus and related ectatic disorders are the leading indication for corneal transplantation and the primary concern of refractive surgery screening in the US. Corneal collagen crosslinking (CXL) has emerged as the only effective treatment to stop keratoconus progression by stiffening the corneal stroma. CXL safety and efficacy is determined by its mechanical outcome, but currently morphological not biomechanical parameters are used to characterize CXL. This proposal aims to establish novel functional metrics to quantify the mechanical outcome of corneal crosslinking (CXL) procedures to facilitate future evaluation of their safety and efficacy. The research is highly synergistic with the FDA collaborator Dr. Ilev, whose lab has been working to develop repeatable and optical radiation safe CXL procedures. To address this need, the lab has developed Brillouin microscopy which enables a CXL test methodology by characterizing corneal stiffness in situ and in vivo with three-dimensional resolution. Our central hypothesis is that the stiffening induced by CXL as evaluated by Brillouin microscopy can be used to predict corneal shape, i.e. visual outcome. To test this hypothesis, they will (1) validate Brillouin-derived mechanical metrics to gold-standard compressive mechanical tests; (2) correlate CXL-induced mechanical changes to cornea morphological behavior by inducing dynamic deformation of the cornea with air-puff; and (3) correlate Brillouin corneal profiles after CXL to morphological changes due to increasing intraocular pressure (IOP).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.