Tailored stromal expansion with refractive lenticule for cross-linking the ultrathin cornea
First Author: R.Malik INDIA
Co Author(s): M. Sachdev G. Sachdev R. Sachdev
To evaluate the safety and efficacy of Corneal collagen Cross-linking in thin corneas (less than 400 microns) following intraoperative stromal expansion using refractive lenticules obtained from Small Incision Lenticule Extraction (SMILE)
A tertiary eye-care centre.
A prospective, Interventional case series. Seven eyes of seven patients with progressive keratoconus, with thinnest pachymetry less than 400 micron were included. After epithelial removal, a SMILE lenticule of appropriate thickness was placed on the stroma, and conventional corneal cross-linking was done. At the end, the lenticule was removed, and a bandage contact lens was placed on the cornea. Follow up period : postoperative day 1 , 5 , 15 , 1 month, 3 months and 6 months. Complete ophthalmic evaluation including Slit Lamp evaluation, specular microscopy, anterior segment OCT and corneal topography.
An improved and stable keratometry was noted at the end of 6 months’ follow-up. Resolution of post-cross linking haze at the end of two months was similar to traditional cross-linking. A clear demarcation line ranging from 280 to 310 microns was clearly seen. No significant endothelial cell loss was seen. Best corrected visual acuity of 20/30 or better was seen in all patients. No intra-operative complications were noted.
Myopic lenticule assisted CXL is a safe and effective technique to perform CXL in ultrathin corneas not otherwise amenable to CXL.