Corneal Stability After Stromal Lenticule Addition Keratoplasty Combined With Cross-Linking For Keratoconus: One-Year Results
Published 2025 - 43rd Congress of the ESCRS
Reference: FP19.08 | Type: Free paper | DOI: 10.82333/xg4q-sg40
Authors: Kjell Gunnar Gundersen* 1 , Steffen Østenstad 1 , Viswanathan Ramasubramanian 2 , Rajaraman Suryakumar 2
1Eye,iFocus Øyeklinikk,Haugesund,Norway, 2R&D,Alcon Research LLC,Forth Worth,United States
Purpose
This study aimed to evaluate the corneal stability in terms of keratometry and posterior corneal elevation after femtosecond laser-assisted stromal lenticule addition keratoplasty combined with crosslinking (SLAK-CXL) for severe keratoconus.
Setting
This retrospective clinical trial was conducted in a tertiary hospital.
Methods
This retrospective study included twenty-four eyes of 22 severe keratoconus patients. The morphological indices regarding corneal thickness, keratometry, and elevation data were assessed using a Scheimpflug imaging system. All parameters were measured preoperatively and 1, 3, and 6 months postoperatively. Maximum keratometry (Kmax) anterior and posterior average keratometry (Kavg) along 3-mm, 5-mm, and 7-mm areas were recorded from the curvature map. The posterior corneal elevation (PCE) values of 13 local points were obtained on the temporal, nasal, superior and inferior sides 3-mm (T3, N3, S3, I3), 5-mm (T5, N5, S5, I5), and 7-mm (T7, N7, S7, I7) of the circle and at the center(C).
Results
At 12 months postoperatively, the UDVA remained unchanged compared to baseline. The mean preoperative thinnest corneal thickness (TCT) at the thinnest point was 376.00±5.59µm preoperatively and increased to 433.29±5.61µm at 1 year(P<0.05). The mean Kmax reading increased from 69.44±2.58D preoperatively to 72.70±2.20D at 1 month and then reduced to 67.30±2.02D at 12 months. 3-mm, 5-mm, and 7-mm Kavg increased 1 month after surgery but remained stable afterwards. Posterior corneal surface keratometry exhibited no change throughout the follow-up time. PCE changes showed a backward displacement on N7 points. A forward trend but no statistically significant difference was found on the supra-nasal side.
Conclusions
SLAK-CXL showed an excellent stabilizing effect on halting the progression of severe keratoconus. This tissue augmentation technique thickens the corneal thickness, making it possible to perform laser ablation without loss while increasing the chances of using other procedures in the future.