Aeration And Hypothermia During Corneal Crosslinking

Preventive crosslinking in photorefractive surgery (540 operations) was carried out during ablation by induced secondary radiation. Therapeutic crosslinking for keratoconus, secondary keratoectasias and various pathologies of the cornea (70 operations) was performed by exposure to argon-fluorine excimer laser radiation at pulse energy densities below the ablation threshold. In all cases, a medical ultrasonic nebulizer with mesh solution dispersion technology was used to saturate the cornea with riboflavin. Riboflavin solution was cooled to +5-7ºС. Corneal temperature was measured with a non-contact IR thermometer. A complex of modern diagnostic equipment was used for optometric studies, OCT and corneal densitometry

The use of an ultrasonic nebulizer to saturate the corneal stroma with a pre-cooled riboflavin solution had the effect of aeration and local hypothermia. Mesh technology for dispersing a solution of riboflavin created a stream of aerosol particles with an average size of 3.7±25% µm. Photorefractive keratectomy after preliminary saturation of the stroma with 0.25% isotonic riboflavin solution initiated the damping effect of crosslinking in the underlying layers of the stroma. Therapeutic excimer laser crosslinking revealed all the classic signs of traditional crosslinking. In addition, the effect of refractive modeling of the cornea was noted, which depended on the total radiation dose and the topography of the treated area.

Aeration and local hypothermia during corneal crosslinking can be implemented by creating a stream of aerosol particles of a cooled riboflavin solution using an ultrasonic nebulizer.