{"id":34850,"date":"2021-04-21T09:06:04","date_gmt":"2021-04-21T09:06:04","guid":{"rendered":"https:\/\/www.elza-institute.com\/?p=34850"},"modified":"2021-04-28T12:50:48","modified_gmt":"2021-04-28T12:50:48","slug":"cool-the-cornea-during-cross-linking","status":"publish","type":"post","link":"https:\/\/www.elza-institute.com\/pt\/cool-the-cornea-during-cross-linking\/","title":{"rendered":"\u00c9 \u00fatil arrefecer a c\u00f3rnea durante o processo de reticula\u00e7\u00e3o?"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">Is it useful to cool the cornea during cross-linking? <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">The researchers at ELZA are constantly trying to improve corneal cross-linking. Back in 2013, we identified that oxygen is an essential component of the cross-linking reaction, and its availability limits the rate at which the cross-linking reaction proceeds [1]. <\/span><span class=\"s1\">But when we looked through the literature, we found an interesting phenomenon: lowering the temperature of the cornea, improves oxygen diffusion. This could solve a problem that exists when we try to accelerate the corneal cross-linking procedure by increasing the intensity of UV irradiation: oxygen gets consumed at a faster rate, limiting the effectiveness of the reaction. The original cross-linking reaction required 30 minutes of UV irradiation to stiffen the cornea, using 3 mW\/cm\u00b2 UV irradiation, but accelerating this reaction beyond 10 minutes (at 9 mW\/cm\u00b2 irradiation) starts to result in diminishing returns in terms of how effectively the cornea is strengthened.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\">To find out if this makes a difference, we performed some experiments [2]. We took 112 pig corneas obtained from an abattoir, soaked them in 0.1% riboflavin, and split them into 4 groups: two where we performed accelerated epi-off cross-linking, incubated at either 24\u00b0C, or 4\u00b0C for 10 minutes, and two non-cross-linked control groups, again, one at 4\u00b0C, and the other at 24\u00b0C, again for 10 minutes. We then performed some stress-strain measurements\u00a0<\/span><\/p>\n<p>What did we find? Unsurprisingly, cross-linked corneas were stronger than non-cross-linked corneas. However, we did not observe any additional strengthening effect in the group of corneas cross-linked at 4<span class=\"s1\">\u00b0C over the corneas cross-linked at 24\u00b0C.\u00a0<\/span><\/p>\n<p>This research was published this month in the journal, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7871403\/\">Eye and Vision<\/a>.<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7871403\/\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-34852 size-medium\" src=\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Cover-image-268x300.png\" alt=\"Cooling the cornea corneal cross-linking - biomechanical effect of epithelium-off corneal cross-linking\" width=\"268\" height=\"300\" srcset=\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Cover-image-268x300.png 268w, https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Cover-image-11x12.png 11w, https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Cover-image.png 663w\" sizes=\"(max-width: 268px) 100vw, 268px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p class=\"p1\"><strong><span class=\"s1\">References<\/span><\/strong><\/p>\n<ol>\n<li>Richoz O, Hammer A, Tabibian D, Gatzioufas Z, Hafezi F. The biomechanical effect of corneal collagen cross-linking (Cxl) with riboflavin and UV-A is oxygen dependent. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3860351\/\">Transl Vis Sci Technol<\/a>. 2013;2(7):6.<\/li>\n<li><span class=\"s1\">Abdshahzadeh H, Abrishamchi R, Torres-Netto EA, et al. Impact of hypothermia on the biomechanical effect of epithelium-off corneal cross-linking. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7871403\/\"><i>Eye Vis (Lond)<\/i><\/a>. 2021;8(1):4.<\/span><span class=\"s1\">2.<\/span><\/li>\n<\/ol>\n<p><a href=\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/03\/CXLattheslitlamp-wide.jpg\">\u00a0<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Is it useful to cool the cornea during cross-linking? The researchers at ELZA are constantly trying to improve corneal cross-linking. Back in 2013, we identified that oxygen is an essential component of the cross-linking reaction, and its availability limits the rate at which the cross-linking reaction proceeds [1]. But when we looked through the literature, [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":34853,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[243,214,95],"tags":[478,477,130,100,133,476,475,122],"class_list":["post-34850","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emilio-torres","category-farhad-hafezi","category-scientific-article","tag-cool","tag-cooling","tag-cross-linking","tag-cxl","tag-epi-off","tag-heat","tag-temperature","tag-translational-research"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Corneal cross-Linking at the slit lamp - now in the JRS - The ELZA Institute<\/title>\n<meta name=\"description\" content=\"Is it useful to cool the cornea during cross-linking? 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We...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.elza-institute.com\/pt\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/\" \/>\n<meta property=\"og:site_name\" content=\"The ELZA Institute\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ELZA.Institute\/\" \/>\n<meta property=\"article:published_time\" content=\"2021-04-21T09:06:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-04-28T12:50:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Featured-Image-Hypothermia-CXL.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Mark Hillen\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Mark Hillen\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo estimado de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/\"},\"author\":{\"name\":\"Mark Hillen\",\"@id\":\"https:\/\/www.elza-institute.com\/#\/schema\/person\/e3929262886a5a60dd6965a6bc721d15\"},\"headline\":\"Is it useful to cool the cornea during cross-linking?\",\"datePublished\":\"2021-04-21T09:06:04+00:00\",\"dateModified\":\"2021-04-28T12:50:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/\"},\"wordCount\":323,\"publisher\":{\"@id\":\"https:\/\/www.elza-institute.com\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Featured-Image-Hypothermia-CXL.jpg\",\"keywords\":[\"cool\",\"cooling\",\"Cross-Linking\",\"CXL\",\"epi-off\",\"heat\",\"temperature\",\"Translational Research\"],\"articleSection\":[\"Emilio Torres\",\"Farhad Hafezi\",\"Scientific article\"],\"inLanguage\":\"pt-PT\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/\",\"url\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/\",\"name\":\"Corneal cross-Linking at the slit lamp - now in the JRS - The ELZA Institute\",\"isPartOf\":{\"@id\":\"https:\/\/www.elza-institute.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.elza-institute.com\/de-ch\/ist-es-sinnvoll-die-hornhaut-wahrend-des-crosslinking-zu-kuhlen\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.elza-institute.com\/wp-content\/uploads\/2021\/04\/Featured-Image-Hypothermia-CXL.jpg\",\"datePublished\":\"2021-04-21T09:06:04+00:00\",\"dateModified\":\"2021-04-28T12:50:48+00:00\",\"description\":\"Is it useful to cool the cornea during cross-linking? 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