With the recent FDA approval of corneal collagen crosslinking (CXL) for keratoconus and ectasia, researchers and clinicians alike are already scrambling to expand its utility to treat other ocular conditions such as corneal infections and, most recently, refractive error.1,2

Researchers at Columbia University School of Engineering and Applied Science are using a femtosecond oscillator (an ultrafast laser) to deliver extremely low energy pulses at a high repetition rate to corneal tissue. The resultant crosslinking alters the biochemical and biomechanical properties of the cornea without causing tissue breakdown.2

“If we carefully tailor these changes, we can adjust the corneal curvature and thus change the refractive power of the eye,” said Sinisa Vukelic, PhD, co-author of the study and a lecturer in discipline in the Department of Mechanical Engineering at Columbia, in a press release. “This is a fundamental departure from the mainstream ultrafast laser treatment that is currently applied in both research and clinical settings and relies on the optical breakdown of the target materials and subsequent cavitation bubble formation.”

Dr. Vukelic and his team are working on a clinical prototype they hope to use in clinical trials by the end of the year. He is also looking for ways to predict corneal behavior after laser treatment to better personalize treatment and improve patient vision.

Avedro, manufacturer of the only FDA approved cross linking device, is also investigating the procedure's potential to induce a change in refractive status.

1. Khalili MR, Jahadi HR, Karimi M, Yasemi M. Corneal collagen cross-linking for treatment of bacterial and herpetic keratitis. J Clin Diagn Res. 2017;11(7):NC12-6.
2. Wang C, Fomovsky M, Miao G, et al. Femtosecond laser crosslinking of the cornea for non-invasive vision correction. Nature Photonics. May 14, 2018. [Epub ahead of print].
3. Evarts H. Columbia engineers invent a non-invasive technique to correct vision. Columbia Engineering. May 25, 2018. http://engineering.columbia.edu/news/technique-correct-vision. Accessed May 30, 2018.