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Femto modified keratoconic eyes and intracorneal lenticular transplantation (stromal augmentation technique): an effective alternative to DALK

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Session Details

Session Title: Presented Poster Session: Keratorefractive Results II

Venue: Poster Village: Pod 2

First Author: : L.Daniel Ponniah INDIA

Co Author(s): :    H. Anandan              

Abstract Details


To compare the 6 months outcome of Intra Stromal Lenticular Transplantation (Stromal Augmentation Technique), as an alternative to DALK, in advanced non scarred keratoconic corneas, in an era of redefined corneal therapeutics by femto lasers.


Prospective non randomised comparative clinical study at Dr Agarwals Eye Hospital, South India


Femto laser assisted donor corneal stromal lenticule (140-200 microns thick.,7.5-8.5mm in diameter) is fashioned, and a bed is created intrastromally with 2 incisions 180 ° apart in the non scarred keratoconic eye again using femto lasers, through which the donor lenticule is transplanted for a stromal augmentation. Difference in preoperative and postoperative uncorrected & corrected visual acuity,pacchymetry,anterior & posterior corneal elevation changes, reversal of irregular astigmatism are compared between DALK, Stromal augmentation technique


15 eyes of Stromal Augmentation compared with 15 eyes of DALK Stromal augmentation and DALK improves vision by 4 lines & 2 lines respectively Stromal augmentation and DALK increases central corneal thickness to normal range Stromal augmentation and DALK flattens keratoconus significantly. DALK flattens anterior cornea more (p=0.178), whereas Stromal augmentation flattens posterior cornea more (p=0.001) Stromal augmentation, DALK reverses irregular astigmatism (p <0.05) Post OP Superior /Inferior asymmetry is closer to an assumed acceptable difference of 2D in Stromal augmentation &DALK


The outcome of Intra Stromal Lenticular Transplantation (Stromal Augmentation Technique), in terms of improvement in vision, flattening of cornea, increase in central/paracentral pachymetry (reversal of ectasias), and improvement in irregular astigmatism is comparable to DALK & no worse than DALK, without sacrifice of recipient tissue and suture related events

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