The bio-ring: a new solution for stromal melting after ICRS implantation

Session Details

Session Title: Keratoconus & Secondary Ectasia

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 08:18

Venue: Free Paper Forum: Podium 2

First Author: : E.Jarade LEBANON

Co Author(s): :    M. Issa   W. Chanbour                          

Abstract Details

Purpose:

Stromal melting above the ring is the most feared complication after ICRS implantation which prompt immediate removal of the ring to prevent further complication and hence, losing the therapeutic effect of the ring. Herewith, we report a new technique to replace the manufactured PMMA ring by a biologic ring that is fashioned from a human corneal donor tissue (bio-ring) to: 1) heal the stromal melting; 2) prevent further ring complications and 3) keep the therapeutic effect of the PMMA ring

Setting:

Beirut eye and ENT specialist hospital

Methods:

preparation of Bio-ring: after trephination of 7,75 mm donor cornea, the remaining corneo-scleral ring was trephined with a 9 mm diameter. The obtained 360-degree bio-ring was denuded from the epithelial and endothelial tissue and soaked with alcohol and fortified antibiotic. The desired length of the bio-ring was obtained by cutting the whole ring. Bio-ring Implantation was attained after partially retrieving one side of the PMMA ring and the bio-ring was attached to the PMMA ring by 10-O suture, the PMMA ring was pushed and retrieved from the other side, pulling it slowly in order to install the bio-ring in place

Results:

Bio-ring was inserted to replace 7 rings of 6 eyes of 6 patients that were complicated by stromal melting. 5 cases of INTACS SK and 2 cases of Keraring SI6 210 degrees were successfully replaced with bio-ring. Follow-up after bio-ring ranges from 6 to12 months. The melting areas healed with unremarkable sequel. CDVA and UCDVA remained unchanged after bio-ring insertion compared to pre-melting values. No remarkable complications were reported per-operatively and during the post-operative follow up. Corneal OCT, topography and bio-metric values were reported before and after bio-ring insertion

Conclusions:

Bio-ring insertion proven to be safe and effective in restoring the bio-optical function of the cornea in case of stromal melting after ICRS surgery and avoid losing the optical effect of the inserted ring. Moreover, bio-ring may be considered as an alternative to the manufactured PMMA ring

Financial Disclosure:

None