A Manual Technique for Corneal Allogeneic Intrastromal Ring Segments Without a Femtosecond Laser.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-03-19 DOI:10.1097/ICO.0000000000003853

Takahiko Hayashi, Yusuke Hara, Chihiro Sunouchi, Kentaro Yuda, Takashi Kojima, Naoko Kato, Brendan Cronin, Satoru Yamagami

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引用次数: 0

Abstract

Purpose: To evaluate the outcomes of corneal allogeneic intrastromal ring segments (CAIRS) using a simplified manual technique for treating keratoconus.

Methods: This prospective case series included 5 eyes from 5 patients with keratoconus (4 males, 1 female, mean age 32.5 ± 10.6 years) treated with manual CAIRS. Surgeries were performed under local anesthesia by a single surgeon. An intrastromal pocket for donor tissue implantation was manually created using a spatula, and donor corneas were prepared using a Jacobs CAIRS trephine. Corneal parameters, including higher-order aberrations, coma, and spherical aberrations at a 6 mm diameter, were measured using optical coherence tomography (CASIA SS-1000, Tomey, Japan). Anterior and posterior corneal indices, subjective refractive power, cylinder, spherical equivalent, best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR]), and central corneal thickness. Intra- and postoperative complications were also analyzed.

Results: Over a mean follow-up of 6.4 ± 2.9 months, no complications occurred. BCVA improved from 0.74 ± 0.44 logMAR preoperatively to 0.19 ± 0.66 logMAR (P = 0.043). The maximum keratometry (Kmax) value decreased from 63.6 ± 8.3D preoperatively to 59.6 ± 6.8D postoperatively (P = 0.043). Spherical equivalent improved from -11.2 ± 5.8D to -5.3 ± 3.1D (P = 0.043), and astigmatism reduced from -5.0 ± 3.4D to -3.3 ± 2.9D. Total corneal higher-order aberrations decreased from 5.6 ± 1.6D to 4.2 ± 1.6D postoperatively (P = 0.043).

Conclusions: Manual CAIRS is an effective treatment when a femtosecond laser is not available.

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无飞秒激光人工角膜异体角膜间环段技术研究。

目的：评价角膜同种异体间环段（cair）手术治疗圆锥角膜的效果。方法：本前瞻性病例系列包括5例圆锥角膜患者的5只眼（男4例，女1例，平均年龄32.5±10.6岁）。手术由一名外科医生在局部麻醉下进行。使用抹刀手工制作供体组织植入的角膜内袋，使用Jacobs CAIRS环钻制备供体角膜。使用光学相干层析成像（CASIA SS-1000, Tomey, Japan）测量角膜参数，包括高阶像差、彗差和6 mm直径的球像差。前、后角膜指数、主观屈光度、柱面、球面等效、最佳矫正视力（BCVA）；最小分辨角的对数[logMAR])和角膜中央厚度。并对术中及术后并发症进行了分析。结果：平均随访6.4±2.9个月，无并发症发生。BCVA由术前的0.74±0.44 logMAR改善至0.19±0.66 logMAR （P = 0.043）。最大角膜测量值（Kmax）由术前的63.6±8.3 3d降至术后的59.6±6.8D （P = 0.043）。球等效从-11.2±5.8D提高到-5.3±3.1D (P = 0.043)，散光从-5.0±3.4D降低到-3.3±2.9D。术后角膜总高阶像差由5.6±1.6D降至4.2±1.6D （P = 0.043）。结论：在飞秒激光无法获得的情况下，手动椅是一种有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.