Femto-Cairs For Keratoconus Using The Brisbane Nomogram
Published 2025 - 43rd Congress of the ESCRS
Reference: PO566 | Type: Free paper | DOI: 10.82333/9zfa-at74
Authors: Francisco Pastor-Pascual* 1 , Rafael Pastor-Pascual 1 , Pedro Tañá-Sanz 2 , Santiago Tañá-Sanz 2 , Pedro Tañá-Rivero 2
1Oftalvist,Valencia,Spain, 2Oftalvist,Alicante,Spain
Purpose
To evaluate the outcomes of femtosecond laser created corneal allogenic intrastromal ring segments (femto-CAIRS) in keratoconic eyes and compare outcomes based on cross-linking status.
Setting
Private Ophthalmology clinic, Brisbane, Australia.
Methods
125 eyes underwent femto-CAIRS between November 2021 and November 2024. 55 eyes were included in the analysis (after excluding eyes with prior ocular surgery, corneal scarring, other ocular disease, and follow-up less than 3 months). Visual acuity, refractive error, corneal topography, and higher order aberrations were measured prior to surgery and 3 months postoperatively. All CAIRS were created using femtosecond laser and the Brisbane nomogram was used to determine segment width, thickness, arc length, axis of implantation, and channel depth according to individual corneal topography. 15 eyes had cross-linking (CXL) prior to CAIRS surgery (prior-CXL), 11 had same day CXL (SD-CXL), and 29 did not have CXL (no-CXL).
Results
Following femto-CAIRS, there were significant improvements in visual acuity, refractive error, refractive and topographic astigmatism, flattening of the central cornea, and a reduction in total higher order aberrations. UDVA improved by 0.4 logMAR and CDVA by 0.2 logMAR. The mean spherical equivalent reduced from -2.90 ± 3.39D to -0.33 ± 1.96D, and refractive astigmatism from -4.51 ± 2.00D to -3.10 ± 1.90D. Mean K decreased from 49.4 ± 5.0D to 45.3 ± 3.7D and KMax from 58.3 ± 7.5D to 55.8 ± 6.2D. There was a greater reduction in flat K and mean K in the prior-CXL compared to the no-CXL group, and the reduction in KMax was greater in the SD-CXL group compared to the no-CXL group. One eye had partial extrusion of the segment on day 3.
Conclusions
Use of the Brisbane nomogram with femto-CAIRS allows for a tailored treatment approach to each eye and results in improved visual acuity and regularization of the central cornea. Larger studies with long-term follow up are needed to further validate this nomogram, and to further examine the effect of CXL on the efficacy of CAIRS surgery.