@article {281106,
	title = {UV cross-linking of donor corneas confers resistance to keratolysis.},
	journal = {Cornea},
	volume = {33},
	number = {9},
	year = {2014},
	month = {2014 Sep},
	pages = {955-9},
	abstract = {PURPOSE: The aim of this study was to develop a modified ex vivo corneal cross-linking method that increases stromal resistance to enzymatic degradation for use as a carrier for the Boston keratoprosthesis. METHODS: Ex vivo cross-linking of human corneas was performed using Barron artificial anterior chambers. The corneas were deepithelialized, pretreated with riboflavin solution (0.1\% riboflavin/20\% dextran), and irradiated with ultraviolet A (UV-A) light (λ = 370 nm, irradiance = 3 mW/cm) for various durations. The combined effect of UV-A and gamma (γ) irradiation was also assessed using the commercially available γ-irradiated corneal donors. The corneas were then trephined and incubated at 37{\textdegree}C with 0.3\% collagenase A solution. The time to dissolution of each cornea was compared across treatments. RESULTS: Deepithelialized corneas (no UV light, no riboflavin) dissolved in 5.8 {\textpm} 0.6 hours. Cross-linked corneas demonstrated increased resistance to dissolution, with a time to dissolution of 17.8 {\textpm} 2.6 hours (P \&lt; 0.0001). The corneal tissues{\textquoteright} resistance to collagenase increased with longer UV-A exposure, reaching a plateau at 30 minutes. Cross-linking both the anterior and posterior corneas did not provide added resistance when compared with cross-linking the anterior corneas only (P \&gt; 0.05). γ-irradiated corneas dissolved as readily as deepithelialized controls regardless of whether they were further cross-linked (5.6 {\textpm} 1.2 hours) or not (6.1 {\textpm} 0.6 hours) (P = 0.43). CONCLUSIONS: Collagen cross-linking of the deepithelialized anterior corneal surface for 30 minutes conferred optimal resistance to in vitro keratolysis by collagenase A.},
	issn = {1536-4798},
	doi = {10.1097/ICO.0000000000000185},
	author = {Arafat, Samer N and Robert, Marie-Claude and Shukla, Anita N and Dohlman, Claes H and Chodosh, James and Ciolino, Joseph B}
}
