Stromal Lenticule Addition Keratoplasty (SLAK) for the Management of Severe Corneal Flattening After Corneal Cross-linking.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2026-08-01 DOI:10.3928/1081597X-20260629-01

George D Kymionis, Vasileios A Tsagkogiannis, Dionysios G Vakalopoulos, Petros C Petrou

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引用次数: 0

Abstract

Purpose: To report the first case of stromal lenticule addition keratoplasty performed for the management of severe progressive corneal flattening following corneal cross-linking (CXL).

Methods: A 63-year-old woman with keratoconus, previously treated with combined topography-guided photorefractive keratectomy and CXL (Athens protocol), presented with progressive corneal flattening and a hyperopic shift in the left eye. Corrected distance visual acuity (CDVA) was 20/50 with manifest refraction of +5.00 -1.50 × 123° and the mean keratometry was 36.20 diopters (D). Stromal lenticule addition keratoplasty was performed using a stromal lenticule obtained from a myopic small incision lenticule extraction treatment. A femtosecond laser was used to create an intrastromal pocket, and the lenticule was inserted and centered within the stromal interface.

Results: Postoperatively, mean keratometry increased to 41.20 D and refraction improved to +0.50 -2.00 × 110°, with 20/40 CDVA. Corneal curvature remained stable at 12 months postoperatively.

Conclusions: Stromal lenticule addition keratoplasty may represent a safe and effective minimally invasive surgical option for inhibiting the progressive corneal flattening, restoring corneal curvature and correcting the excessive hyperopia in cases of severe corneal flattening following CXL.

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基质晶状体添加角膜移植术（SLAK）治疗角膜交联后严重角膜扁平。

目的：报道首例角膜交联（CXL）后严重进行性角膜扁平化的间质晶状体角膜移植手术。方法：一名63岁女性圆锥角膜患者，先前接受了地形引导下的光屈光性角膜切除术和CXL（雅典方案）联合治疗，出现了进行性角膜变平和左眼远视移位。矫正距离视力（CDVA）为20/50，明显屈光度为+5.00 -1.50 × 123°，平均角膜屈光度为36.20屈光度(D)。间质晶状体添加角膜移植术采用从近视小切口晶状体提取治疗中获得的间质晶状体。飞秒激光被用来制造一个基质内袋，透镜被插入基质界面并居中。结果：术后平均角膜度数增加至41.20 D，屈光度改善至+0.50 -2.00 × 110°，CDVA为20/40。术后12个月角膜曲率保持稳定。结论：间质小晶状体角膜移植术是一种安全有效的微创手术方法，可抑制角膜渐进性扁平化，恢复角膜曲度，矫正CXL术后严重角膜扁平化。

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

$Journal of refractive surgery$

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.