Experimental Use of Ozone in Cross-Linking: Transforming Keratoconus Management


Dogan A. S., Gurdal C., Caliskan S., Onder E., Isgoren A., Toprak Tellioglu H.

Current Eye Research, cilt.51, sa.2, ss.118-124, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 51 Sayı: 2
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1080/02713683.2025.2569058
  • Dergi Adı: Current Eye Research
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Sayfa Sayıları: ss.118-124
  • Anahtar Kelimeler: Cornea biomechanics, corneal cross-linking, keratoconus, ozone
  • Ankara Üniversitesi Adresli: Evet

Özet

Purpose: Keratoconus is a progressive corneal disorder characterized by thinning of the stromal layer. Corneal cross-linking (CXL), a widely used treatment, focuses on improving corneal strength by enhancing collagen cross-links. Alternative methods are being explored to increase the efficacy of CXL. This study aims to evaluate whether ozone, as a strong oxygen donor, can be utilized as an adjuvant or standalone cross-linking agent in an in vivo model. Methods: The study involved 12 New Zealand albino rabbits, which were divided into three treatment groups, each receiving a different therapy: (1) CXL, (2) ozone, and (3) CXL combined with ozone (CXL+ozone). Corneal Visualization Scheimpflug Technology (Corvis ST), Anterior Segment Optical Coherence Tomography (AS-OCT), and Corneal Confocal Microscopy (CCM) measurements were performed post-procedure. Results: Ozone therapy did not result in statistically significant differences compared to CXL in biomechanical parameters. Corvis ST measurements were not significantly different between groups. AS-OCT revealed full-thickness stromal brightness in the CXL+ozone group. CCM imaging showed hyperreflectivity limited to the anterior stroma in the CXL and ozone groups but distributed throughout the stroma in the CXL+ozone group. No adverse effects were observed. Conclusion: Ozone therapy may enhance CXL efficacy and serves as a potential alternative. Its affordability, shorter duration, and comparable clinical outcomes make it particularly promising for resource-limited settings.