1. Meniscus-Shaped Stromal Lenticule Addition Keratoplasty for Corneal Regularization and Thickening in Advanced Keratoconus.
- Author
-
Pedrotti E, Bonacci E, Fasolo A, Fraccaroli S, Anastasi M, Vinciguerra R, Vinciguerra P, and Giorgio M
- Subjects
- Humans, Coma surgery, Corneal Stroma surgery, Cornea surgery, Refraction, Ocular, Corneal Topography, Keratoconus diagnosis, Corneal Transplantation methods
- Abstract
Purpose: The aim of this study was to investigate the outcome of the meniscus-shaped stromal lenticule addition keratoplasty (MS-SLAK) in corneal regularization and thickness., Methods: Patients waiting for deep anterior lamellar keratoplasty for advanced keratoconus with an intolerance to contact lenses (CLs) underwent the MS-SLAK procedure by FSL 80 kHz ablation (VICTUS, Technolas Perfect Vision, DE). Customized positive meniscus-shaped stromal lenticules were obtained and implanted. Examination was performed at baseline and at 3-, 6-, and 12-month follow-up and included corrected distance visual acuity both with spectacles and CLs (spectacle CDVA and CL-CDVA), manifest refraction spherical equivalent, slit-lamp examination, anterior segment optical coherence tomography, corneal topography, and in vivo confocal microscopy., Results: Fifteen patients completed the study. Statistical increases in corneal thickness values were found from the first follow-up ( P < 0.001). Improvement in the Surface Asymmetry Index ( P = 0.04), Symmetry Index ( P = 0.02), spherical aberration ( P < 0.001), coma ( P = 0.18), high-order aberration ( P = 0.37), and anterior asphericity index (Q) ( P = 0.31) were found at 12 months. At the 12-month follow-up, no improvement were found in spectacle CDVA ( P = 0.23); however, all patients reported CL wearing tolerance recovery, and significant improvement in CL-CDVA ( P = 0.002) was found. The confocal microscopy at 12 months showed a significant increase in keratocyte density within the lenticule and absence of fibrotic reactions in both anterior and posterior interfaces., Conclusions: MS-SLAK seems to be effective in regularizing the corneal surface as showed by the significant improvement in topographic symmetry indices, coma, and high-order aberration. The corneal regularization is also confirmed by the results in anterior Q and the recovery of the CL wearing tolerance., Competing Interests: Conflicts of interest statement: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF