Abstract

The debating issues of corneal collagen cross-linking (CXL) will be resolved/analyzed mathematically including: the validation of Bunsen Roscoe law (BRL), the intensity dynamics and its cutoff maximum, the safety criteria, the demarcation depth, and the role of oxygen. In addition to a review, the new protocol using concentration-controlled method will be updated. A new CXL efficacy defined by the product of [strength] (or the maximal value of S) and the [depth] (or z*), i.e., the volume of stroma being cross-linked is introduced. CXL efficacy is shown proportionally related to the demarcation line depth, and both have a cutoff maximum intensity.

Keywords: Corneal crosslinking; Corneal keratoconus; Efficacy; Kinetic modeling; Oxygen; Riboflavin; Ultraviolet light; Photodynamic therapy

Abbreviations: CXL: Corneal Collages Cross-linking; CCM: Controlled-Concentration-Method; RF: Riboflavin; BRL: Bunsen Roscoe Law; AXL: Accelerated CXL; OM: Oxygen-Mediated; NOM: Non-Oxygen-Mediated; PS: Photo Sensitizers; DXL: Dresden Protocol