Corneal Allogenic Intrastromal Ring Segments (Cairs) For Corneal Ectasia: A Comprehensive Segmental Tomography Evaluation
Published 2023 - 41st Congress of the ESCRS
Reference: FP30.07 | Type: Free paper | DOI: 10.82333/ccgq-f502
Authors: Shady Awwad* 1 , Yara Bteich 1 , Jad F. Assaf 2 , Anthony Abou Mrad 2 , Soosan Jacob 3 , Farhad Hafezi 4
1American University of Beirut Medical Center,Beirut,Lebanon, 2American University of Beirut - Faculty of Medicine,Beirut,Lebanon, 3Dr. Agarwal's Eye Hospital,Chennai,India, 4ELZA Institute,Zurich,Switzerland
Purpose
To evaluate the visual, refractive, and tomographic results of patients with corneal ectasia treated with corneal allogenic intrastromal ring segments (CAIRS) without concomitant corneal cross-linking.
Setting
Department of Ophthalmology at the American University of Beirut Medical Center between September 2019 and July 2022
Methods
Fifty-eight eyes from 44 patients with stable corneal ectasia and unsatisfactory visual acuity with contact lenses were included. All patients underwent CAIRS insertion with no concomitant corneal procedure. Visual, refractive, topographic, aberrometric, epithelial, stromal, and segment thickness data were measured relative to baseline at 1 week, 1 month, and at least 3 months postoperatively. Evaluations included slit-lamp examination, manifest refraction, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and tomography using anterior segment optical coherence tomography.
Results
Mean follow-up time was 6.9±5.2 months. UDVA and CDVA improved from 0.97±0.47 and 0.56±0.19 preoperatively to 0.52±0.21 (P<0.001) and 0.23±0.19 (P<0.001) 3 months postoperatively. Manifest refraction spherical equivalent and cylinder improved from -6.71±6.51D and -4.02±2.24D preoperatively to -3.78±4.07D (P<0.001) and -2.35±1.98D (P<0.001) 3 months postoperatively. Maximum anterior keratometry and vertical coma decreased from 58.09±7.92D and 1.56±1.09µm to 52.48±6.69D (P<0.001) and 0.43±0.77µm (P<0.001). Corneal epithelium thickened proximal to the allogenic segment by 7.25µm (P<0.001), while stromal elevation at the cone decreased from 38.61±18.5µm to 23.82±13.4µm (P<0.001). No loss of CDVA lines or major complications were observed.
Conclusions
Treatment of corneal ectasia with CAIRS improving visual, refractive, topographic, and tomographic parameters. Epithelial thickening central to CAIRS, along with anterior stromal flattening is postulated to contribute to tomographic flattening and regularization.