Analysis of Biomechanical Response After Corneal Crosslinking with Different Fluence Levels in Porcine Corneas

This study investigated the mechanical stiffening effects of corneal crosslinking (CXL) at varying UV-A fluence levels in porcine corneas. Ninety eyes were treated with different total fluences (5.4–20 J/cm²) to evaluate dose-dependent biomechanical changes. Stress–strain tests demonstrated a significant increase in stiffness with higher fluence levels, achieving up to 76% greater stress compared to controls at 10% strain. The Young’s modulus increased from 1.62 MPa in controls to 2.85 MPa at 20 J/cm². These results establish a strong dose–response relationship between UV exposure and corneal rigidity, suggesting that higher fluence levels may compensate for reduced efficacy in accelerated or transepithelial CXL procedures.