Uk Experience Of Xenia Lenticule Implantation For Management Of Keratoconus: 4 Year Results

Purpose: The management of keratoconus and post-LASIK ectasia can be challenging. Often these patients have poor
unaided and aided vision; they are often spectacle & contact lens intolerance. We describe a form of SLAK using a
XENIA™ Lenticule - a novel biocompatible corneal lenticule of highly purified corneal collagen fibres of porcine origin.
Four years results of the first 20 patients treated with this technique are presented

Setting: All the patients were treated at Optimax Eye Clinics in England, United Kingdom. A single surgeon (1st author)
treated all the 20 patients. Patients were recruited following referral from other Eye Centres; all patients were
counselled, explained all other options and informed consenting form completed

^{Methods: A total of 20 eyes of 19 patients have undergone the procedure. 17 eyes with keratoconus and 3 with post-
LASIK ectasia.. A custom corneal stromal pocket of 100 to 200μm depth and 8.7mm diameter was created with a 3.7 mm
access port using an Intralase femtosecond laser. A 120μm thick (initial 6 patients, 80 microns thick for 3 patients and 45
microns thick Xenia for remaining patients), 7.2/8 mm diameter Gebauer™ lenticule was implanted into this stromal pocket though
the 3.7 mm port. No sutures were used. Pre and post operative topography, pachymetry, intraocular pressures were
recorded as well as aided, unaided and corrected vision}

Results: Following implantation of the lenticule, average corneal thickness was increased from 401μm to 513μm.
Average optical k readings were not statistically altered (51.4 D vs 51.5D). Anterior corneal astigmatism decreased from
7.4 D to 2.0D. Unaided vision improved from 1.74 LogMar to 1.54 LogMar

One of the patient who received the newer generation Xenia implant achieved 6/6 unaided vision within 48 hours of surgery; her corneal astigmatism was reduced to plano

Conclusions: The XENIA Implant - 4 years results seems to be very promising in stabilising keratoconic and post-lasik
ectasia eyes. With the 110 microns cohort, 3 patients developed cloudiness of the Xenia; 45 microns XENIA
Implants seem to be more effective and remained transparent. Epithelium off or on doesnt seems to make any
difference. Deeper the femtosecond pocket, better the flattening of the postoperative keratometry values. The newer generation Xenia implants have shown marked mprovement in the unaided vision