Crosslinked All-Femtosecond Laser-Cut Corneal Allogenic Intracorneal Ring Segments (Afxl Cairss): Pilot Ex Vivo Study And Case Series
Published 2025 - 43rd Congress of the ESCRS
Reference: PP02.07 | Type: Free paper | DOI: 10.82333/a1ma-jc67
Authors: Pascal Rozot* 1
1Clinique Juge,Marseille,France
Purpose
The ex vivo study and first clinical case series evaluate the impact of first international use of pre-implantation crosslinking on all-femtosecond laser-cut corneal allogenic intracorneal ring segments (AFXL CAIRS).
Setting
Vampolieri eye Clinic - Siena Cross-linking Center
Six human donor eye-bank corneas were used for this preclinical ex vivo human study. Three donor (D) corneas were used for AFXL CAIRSs. First, they were prepared with an IntraLaseTM femtosecond laser (Johnson & Johnson, New Brunswick, NJ, USA).
Methods
The allogenic tissue rings were crosslinked before implantation with Riboflavin–UV-A M nomogram accelerated crosslinking protocol (ACXL) with a 0.1% HPMC Riboflavin isotonic solution (Vibex Rapid, Glaukos-Avedro, Burlington, MA, USA) and a new KXL UV-A emitter (Glaukos-Avedro, USA). Three corneas were used as recipients (Rs) of the AFXL CAIRSs. After completing the ex vivo phase, IRB approval and signing a specific informed consent, the first two Italian patients were treated. A case series of ACXL CAIRS is presented with a personalized nomogram of pre-crosslinked CAIRS implantation and wire assisted surgical technique in a 12 months follow-up.
Results
Crosslinking of the segments enhanced tissue stiffness and grip, facilitating manipulation and CAIRS insertion into the recipient tunnels, and the yellowish color of the crosslinked segments improved visibility. The segment’s thickness and volume remained unaltered during the follow-up. All treated patients showed an improved BSCVA. K steep and High-Order Aberrations (HOAs) were reduced and MCT increased.
Conclusions
the study proved that pre-implantation ACXL facilitated CAIRS insertion preserving dimensions and implant’s volume during the follow-up, rendering this important step a promising candidate in CAIRS method standardization. Functional data and MCT improved significantly without adverse events.