Posters

Innovative use of a DSAEK lenticule in cross-linking thin corneas: our experience

Poster Details

First Author: R.Shroff INDIA

Co Author(s):    D. Chauhan   D. Mathur                 

Abstract Details

Purpose:

To study the safety and efficacy of a novel new protocol for collagen cross-linking in thin corneas using a DSAEK (Descemets stripping automated endothelial keratoplasty) lenticule. To evaluate the change in visual, refractive and tomographic parameters in patients with progressive keratoconus in subjects treated using this protocol.

Setting:

A tertiary eye car centre in North India (Shroff Eye Centre)

Methods:

Prospective interventional study. 20 eyes of 14 patients with progressive keratoconus underwent corneal collagen cross-linking (CXL). Corneas with a thickness of less than 400 microns were included. A spatula was used to debride the central 9.0 mm of epithelium. A DSAEK Lenticule from therapeutic grade corneal tissue was prepared using a microkeratome and trephined to a diameter of 8mm. The lenticule was placed and CXL was performed (18mw/ sq cm for 5 minutes). Changes in corrected distance visual acuity(CDVA), spherical equivalent (SE), flat keratometry, steep keratometry, thinnest pachymetry, specular microscopy, and demarcation line were studied at 3 and 6 months.

Results:

Improvement in the mean Corrected distance visual acuity (CDVA) and Spherical equivalent were statistically significant (p = 0.03 and p = 0.02) respectively. The flat keratometry changed from (51.44 + 1.87) to (49. 76 + 1.44) which was statistically significant (p=0.048). The steep keratometry changed from (55.65 + 1.77) to (52.35 + 1.65) and this was statistically significant (p = 0.03). Demarcation line was noted in 16 eyes. There was no significant change in the endothelial cell count before and after the procedure (p = 0.88)

Conclusions:

Crosslinking in thin corneas is an evolving science. The use of a DSAEK lenticule procured from therapeutic grade tissue is a safe and effective alternative to known techniques using hypotonic riboflavin, transepithelial CXL and tailored stromal expansion using a SMILE lenticule. Further studies are required to achieve optimal outcomes.

Financial Disclosure:

None