title: Biomechanical Changes of Collagen Cross-Linking on Human Keratoconic Corneas Using Scanning Acoustic Microscopy.
abstract: To assess the biomechanical changes of collagen cross-linking on keratoconic corneas in vitro.
  
  
  
  Six keratoconic corneal buttons were included in this study. Each cornea was divided into two halves, where one half was cross-linked and the other half was treated with riboflavin only and served as control. The biomechanical changes of the corneal tissue were measured across the stroma using scanning acoustic microscopy (SAM).
  
  
  
  In the cross-linked corneas, there was a steady decrease in the magnitude of speed of sound from the anterior region through to the posterior regions of the stroma. The speed of sound was found to decrease slightly across the corneal thickness in the control corneas. The increase in speed of sound between the cross-linked and control corneas in the anterior region was by a factor of 1.039×.
  
  
  
  A higher speed of sound was detected in cross-linked keratoconic corneal tissue when compared with their controls, using SAM. This in vitro model can be used to compare to the cross-linking results obtained in vivo, as well as comparing the results obtained with different protocols.
authors.affiliation: a Optometry Department, Faculty of Medicine and Health Sciences , An-Najah National University , Nablus , State of Palestine .
authors.forename: Ithar M
authors.initials: IM
authors.lastname: Beshtawi
authors.affiliation: b Centre for Materials and Structures, School of Engineering, University of Liverpool , Liverpool , UK .
authors.forename: Riaz
authors.initials: R
authors.lastname: Akhtar
authors.affiliation: c Stopford Building, Centre For Tissue Injury and Repair, Institute of Inflammation and Repair, University of Manchester , Manchester , UK .
authors.forename: M Chantal
authors.initials: MC
authors.lastname: Hillarby
authors.affiliation: d Optegra Eye Sciences, Optegra Manchester Eye Hospital , Manchester , UK .
authors.forename: Clare
authors.initials: C
authors.lastname: O'Donnell
authors.affiliation: e Manchester Materials Science Centre, School of Materials, The University of Manchester , Manchester , UK .
authors.forename: Xuegen
authors.initials: X
authors.lastname: Zhao
authors.affiliation: f Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK and.
authors.forename: Arun
authors.initials: A
authors.lastname: Brahma
authors.affiliation: f Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK and.
authors.forename: Fiona
authors.initials: F
authors.lastname: Carley
authors.affiliation: e Manchester Materials Science Centre, School of Materials, The University of Manchester , Manchester , UK .
authors.forename: Brian
authors.initials: B
authors.lastname: Derby
authors.affiliation: g Faculty of Life Sciences , The University of Manchester , Manchester , UK.
authors.forename: Hema
authors.initials: H
authors.lastname: Radhakrishnan
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000627:therapeutic use*; D003315:Cornea / Q000473:pathology / Q000503:physiopathology*; D003432:Cross-Linking Reagents / Q000627:therapeutic use; D004548:Elasticity; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D033401:Microscopy, Acoustic / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012256:Riboflavin / Q000627:therapeutic use*; D014466:Ultraviolet Rays; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: Collagen cross-linking; keratoconus; scanning acoustic microscopy