Corneal Erosions Following Xenia Implant

To analyse the long term complcations following Xenia lenticule insertion in a cohort of 14 patients (15 eyes) from an Eye Centre in the United Kingdom

The management of high astigmatism and myopia in cases of keratoconus and post-LASIK ectasia can be challenging. XENIA™ Lenticule - a novel biocompatible corneal lenticule of highly purified corneal collagen fibres of porcine origin has been used to improve the corneal profile in keratoconic patients. Two of our pateints developed persistent corneal erosions which failed to heal inspite of further management with lubricants, bandage contact lens; finally the XENIA lenticule was removed to support the healing process

All patients underwent treatment at the Optimax Laser Eye Clinic, Leicester, United Kingdom over a period of 2 years. SIngle Surgeon performed all the treatments using Intralase Femtosecond and XENIA Lenticule

A total of 15 eyes of 14 patients have undergone the procedure. 12 eyes with keratoconus and 3 with post-LASIK ectasia..  A custom corneal stromal pocket of  upto 170μm depth and 8.7mm diameter was created with a 3.7 mm access port using an Intralase femtosecond laser. Lenticules of varying thickness ranging from 40 to 120μm thick, 7.2mm diameter Gebauer™ lenticule was implanted into this stromal pocket though the 3.7 mm port.  No sutures were used.  Post operatively topical dexamethasone  and chloramphenicol were used four times a day. Pre and post operative topography, pachymetry, intraocular pressures were recorded as well as aided, unaided and corrected vision.

• 15 patients treated so far
• 3 post Lasik Ectasia & 12 Keratoconus
• Better unaided Vision (1.74 to 1.54 LogMar)
• Thicker cornea after surgery (401 to 513 microns)
• Corneal “K” reading flattens postop (51 to 53 dioptres)
• Better tolerance of CL/spectacles
• Post Lasik Ectasia – doing better compared with keratoconics
• 2 patients had a dramatic improvement in unaided distance vision within a few days (CF to 6/12-3)
• 2 patients developed corneal erosion and needed removal of Xenia
• Corneal thickness & “K” readings improved in all patients
• Corneal curvature remained flat even after removal of the Xenia in those 2 patients

Femtosecond intrastromal pocket creation helps to flatten the corneal profile permanently. The unaided vision has remained better than preoperative level even afer removal of the XENIA Lenticule in those 2 patients. Change in the corneal thickness hasnt adversely affect the final outcome