Ultraviolet A (UVA) light-based photoactivation of riboflavin (Rf) to induce corneal crosslinking (CXL) and mechanical stiffening is now a well-known treatment for corneal ectasia and Keratoconus that is being used in a topographically guided photorefractive intrastromal CXL (PiXL) procedure to treat low degrees of refractive errors. Alternative approaches for non-invasive treatment of refractive errors have also been proposed that use femtosecond lasers (FS) that provide much faster, more precise, and safer results than UVA CXL. One such treatment, nonlinear optical crosslinking (NLO CXL), has been able to replicate the effects of UVA CXL, while producing a smaller area of cellular damage and requiring a shorter procedure time. Unlike UVA CXL, the treatment volume of NLO CXL only occurs within the focal volume of the laser, which can be placed at any depth and scanned into any pattern for true topographically guided refractive correction. This review presents our experience with using FS lasers to photoactivate Rf and perform highly controlled corneal CXL that leads to mechanical stiffening and changes in corneal shape.

紫外线 A (UVA) 光激活核黄素 (Rf) 以诱导角膜交联 (CXL) 和机械硬化现在是众所周知的角膜扩张和圆锥角膜的治疗方法，用于地形引导的光折射基质内 CXL (PiXL)治疗低度屈光不正的手术。还提出了非侵入性治疗屈光不正的替代方法，使用飞秒激光 (FS) 提供比 UVA CXL 更快、更精确和更安全的结果。一种这样的治疗，非线性光学交联 (NLO CXL)，已经能够复制 UVA CXL 的效果，同时产生更小的细胞损伤区域并需要更短的程序时间。与 UVA CXL 不同，NLO CXL 的治疗体积仅发生在激光的焦点体积内，它可以放置在任何深度并扫描成任何图案，以进行真正的地形引导屈光矫正。这篇综述介绍了我们使用 FS 激光光激活 Rf 并执行高度受控的角膜 CXL 的经验，这导致机械硬化和角膜形状的变化。