Porcine Collagen Implants in Advanced Keratoconus: Outcomes at 1 Year.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2025-03-01 DOI:10.3928/1081597X-20250207-02

Rashmi Deshmukh, Raj M Mohan, Vyshna Madonadi Kuniyil, Pravin Krishna Vaddavalli

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引用次数: 0

Abstract

Purpose: To report the visual and tomographic outcomes 1 year after porcine collagen lenticule implantation in eyes with advanced keratoconus.

Methods: Patients older than 18 years with advanced keratoconus having central corneal thickness (CCT) greater than 350 µm and visual acuity of 20/40 or better with contact lens, but intolerant to contact lenses, were included. A femtosecond laser-assisted stromal pocket was created at a depth of 140 µm. A Xenia implant (Gebauer Medizintechnik GmbH) was inserted into the stromal pocket using a glide. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity testing, slit-lamp evaluation, corneal topography using Pentacam (Oculus Optikgeräte GmbH), and anterior segment optical coherence tomography using Optovue (XR-Avanti) was performed preoperatively and at 1 week, 1, 3, and 6 months, and 1 year after Xenia lenticule implantation.

Results: Nine eyes of 9 patients (6 men and 3 women) with a mean age of 28.4 years underwent Xenia lenticule implantation. Mean UDVA and CDVA improved from 1.43 ± 0.3 to 0.78 ± 0.17 logMAR (P = .0087) and 0.89 ± 0.13 to 0.45 ± 0.03 logMAR (P = .0005) at 1 year. The preoperative mean flat keratometry (K1) was 61.29 ± 3.76 diopters (D), steep keratometry (K2) was 68.09 ± 4.41 D, CCT was 354.71 ± 9.30 µm, average keratometry (Kmean) was 64.50 ± 3.98 D, and maximum keratometry (Kmax) was 77.07 ± 6.01 D. All keratometry values showed statistically significant flattening at 1 year with mean K1 of 40.70 ± 3.96 D (P = .0003), K2 of 43.80 ± 4.04 D (P = .0005), Kmean of 42.20 ± 4.00 D (P = .0003), and Kmax of 61.53 ± 4.70 D (P = .0152). There were no episodes of graft rejection. Two eyes had stromal melt within 3 months postoperatively, requiring lenticule explantation.

Conclusions: Significant improvement in UDVA, CDVA, and keratometry values was noted in patients undergoing Xenia lenticule implantation in advanced keratoconus. Preliminary results demonstrate that Xenia lenticule implantation could be an alternative to keratoplasty and human stromal lenticule implants in cases with advanced keratoconus. [J Refract Surg. 2025;41(3):e272-e279.].

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猪胶原植入治疗晚期圆锥角膜1年的疗效

目的：报道晚期圆锥角膜植入术后1年的视力和体层检查结果。方法：纳入年龄大于18岁、角膜中央厚度（CCT）大于350µm、视力在20/40及以上、配戴隐形眼镜但对隐形眼镜不耐受的晚期圆锥角膜患者。在140µm的深度处创建了飞秒激光辅助基质袋。Xenia植入物（Gebauer Medizintechnik GmbH）通过滑动植入基质口袋。术前、Xenia晶状体植入后1周、1、3、6个月和1年分别进行未矫正（UDVA）和矫正（CDVA）距离视力测试、裂隙灯评估、Pentacam （Oculus Optikgeräte GmbH）角膜地形图和Optovue （XR-Avanti）前段光学相干断层扫描。结果：9例患者9眼（男6例，女3例）行Xenia晶状体植入术，平均年龄28.4岁。平均UDVA和CDVA在1年内从1.43±0.3 logMAR改善到0.78±0.17 logMAR (P = 0.0087)，从0.89±0.13 logMAR改善到0.45±0.03 logMAR （P = 0.0005）。术前的意思是平的角膜散光计(K1)是61.29±3.76度(D),陡峭的角膜散光计(K2)为68.09±4.41 D,有条件现金转移支付为354.71±9.30µm,平均角膜散光计(Kmean)为64.50±3.98 D,和最大角膜散光计(Kmax)为77.07±6.01 D所有角膜散光计值显示统计上显著的压扁在1年的意思是K1 40.70±3.96 D (P = .0003), K2 43.80±4.04 D (P = .0005), Kmean 42.20±4.00 D (P = .0003),和Kmax 61.53±4.70 D (P = .0152)。没有出现移植排斥反应。2只眼术后3个月内间质融化，需要晶状体移植。结论：晚期圆锥角膜患者行Xenia晶状体植入术后，UDVA、CDVA和角膜测量值均有显著改善。初步结果表明，Xenia晶状体植入术可替代角膜移植术和人间质晶状体植入术治疗晚期圆锥角膜。[J].中华眼科杂志，2015;41(3):779 - 779。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.