Posters

Implantation of intrastromal allograft corneal segment (ISACS) for treatment of pellucid marginal degeneration (PMD)

Poster Details

First Author: M.Jafarinasab IRAN

Co Author(s): Y. Hadi   S. Safi                 

Abstract Details

Purpose:

Management of pellucid marginal degeneration (PMD) is a subject of ongoing research in the field of corneal ectasia. There is no universally accepted method for managing these patients, especially subjects who cannot wear any type of contact lens. In the current pilot study we introduce a new surgical method for management of thinning and high irregular astigmatism due to PMD.

Setting:

Labbafinejad Medical Center,Department of Ophthalmology, Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of); 2,Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic

Methods:

In this prospective study, we implanted allograft Intrastromal corneal segment (ISACS)in four eyes of 3 patients with PMD as a new surgical procedure. A femtosecond laser-assisted stromal canal 4 mm in width was created in the 5.5 to 9.5 mm corneal zone. An ISACS was implanted in the canals. A new handmade spatula was used for implantation (video). Dimensions of the implanted ISACS were ring shaped with width of 2 mm and arc length of 160,and 210 degree in two eyes and crescent shaped with maximum width of 3mm and arc length of 180 degree in two eyes

Results:

Uncorrected visual acuity and best-corrected visual acuity was improved after surgery in all eyes on all examination. Both myopia and astigmatism were reduced in all cases and were stable during 12 months follow up. The steep areas were displaced superiorly and the amount of irregular astigmatism was reduced on topography (included Figure). Implanted ISACSs were clear and stable on the day after implantation and thereafter on all examinations during the follow up period. No significant side effect or complication was observed during the one year follow up period.

Conclusions:

ISACS is a safe, effective and inexpensive method for management of PMD, with advantages of more flexible ,customized shape (ring segment, crescent shaped), width ,arch length and thickness. Longer follow up and larger sample size are needed to confirm our findings.

Financial Disclosure:

None