In vivo monitoring of the corneal collagen cross-linking using supersonic shear wave imaging: feasibility study on porcine corneas

Abstract : The cornea is the main refractive component of the eye. Defects in corneal shape can reduce the visual acuity. Corneal ectasia is a case of severe deformation, which is characterized by a progressive bulging. It can occur naturally or after LASIK surgery, leading to damaged vision and ultimately blindness. Corneal cross-linking (CXL) has recently been proposed as a minimally invasive treatment to stop the disease progression. It consists in photo-reticulating the collagen fibrils to stiffen the cornea. However, this treatment is currently not monitored in real-time. Here, we propose Supersonic Shear Wave Imaging (SSI) to measure the stiffening effect of CXL. SSI elastography consists in generating and tracking a shear wave in tissues using ultrafast (30000 frames/sec) ultrasonic scanners (Aixplorer, SuperSonic Imagine). The tissue elasticity is deduced from the shear wave speed. For corneal applications, we implemented SSI on high-frequency ultrasonic arrays (15MHz). We performed in vivo CXL on anesthetized pigs combined with SSI monitoring. We obtained elastic maps after CXL that exhibited significant stiffening in the treated area (56 ± 15% of the shear wave speed) compared to the untreated area. These results demonstrated the feasibility of SSI for the in vivo and real-time monitoring of CXL.
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Thu-Mai Nguyen, Jean-François Aubry, David Touboul, Jeremy Bercoff, Mickaël Tanter. In vivo monitoring of the corneal collagen cross-linking using supersonic shear wave imaging: feasibility study on porcine corneas. Acoustics 2012, Apr 2012, Nantes, France. ⟨hal-00810813⟩

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