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Corneal tissue addition keratoplasty: new intrastromal inlay procedure for keratoconus using femtosecond laser-shaped preserved corneal tissue.

Authors :
Greenstein SA
Yu AS
Gelles JD
Eshraghi H
Hersh PS
Source :
Journal of cataract and refractive surgery [J Cataract Refract Surg] 2023 Jul 01; Vol. 49 (7), pp. 740-746.
Publication Year :
2023

Abstract

Purpose: To report results of Corneal Tissue Addition Keratoplasty (CTAK) for keratoconus (KC) and ectasia after laser in situ keratomileusis.<br />Setting: Cornea and refractive surgery practice.<br />Design: Single center, prospective, open label clinical trial.<br />Methods: 21 eyes of 18 patients underwent CTAK. A tissue inlay of preserved corneal tissue was cut to customized specifications with a femtosecond laser and placed in a laser-created channel in the host cornea. Postoperative uncorrected and corrected distance visual acuity (UDVA, CDVA), manifest refraction spherical equivalent (MRSE), topographic mean keratometry (Kmean), maximum keratometry (Kmax), and the point of maximum flattening (Kmaxflat) were measured.<br />Results: Average UDVA improved from 1.21 ± 0.35 logMAR lines (LL) (20/327) to 0.61 ± 0.25 LL (20/82) ( P < .001). Average CDVA improved from 0.62 ± 0.33 LL (20/82) to 0.34 ± 0.21 LL (20/43) ( P = .002), and average MRSE improved from -6.25 ± 5.45 diopters (D) to -1.61 ± 3.33 D ( P = .002). Individually, 20 eyes (95.2%) gained more than 2 lines of UDVA, with 10 eyes (47.6%) gaining more than 6 lines, and no eyes worsening. 12 eyes (57.1%) gained at least 2 lines of CDVA, with 1 eye worsening by more than 2 lines. At 6 months, average Kmean flattened by -8.44 D ( P = .002), Kmax flattened by -6.91 D ( P = .096), and mean Kmaxflat was -16.03 D.<br />Conclusions: CTAK is a promising procedure to improve visual acuity and topography in patients with KC and ectasia.<br /> (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Details

Language :
English
ISSN :
1873-4502
Volume :
49
Issue :
7
Database :
MEDLINE
Journal :
Journal of cataract and refractive surgery
Publication Type :
Academic Journal
Accession number :
36943309
Full Text :
https://doi.org/10.1097/j.jcrs.0000000000001187