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Stromal keratoplasty offers surgical alternative for stromal pathologies
SAN DIEGO — Stromal keratoplasty is a new surgical option for stromal pathologies that offers quick recovery of the epithelial surface, according to a surgeon speaking here.
Cesar C. Carriazo, MD, presented his outcomes using the procedure at the American Society of Cataract and Refractive Surgery meeting. He reported outcomes for three patients who underwent the procedure for keratoconus.
"With stromal keratoplasty, we first create a disc, we use a laser to remove the stroma, we place the donor in position, and after that we replace the disc to its original position," he said.
In all cases, surgeons created a 100-µm thick, 9.5-mm diameter corneal flap and performed a pachymetry-assisted ablation 8-mm in diameter.
Surgeons then placed an 8-mm donor graft stripped of endothelium and epithelium, and sutured both it and the flap in place.
The epithelial surface of the flap was preserved at 24 hours postop. Uncorrected visual acuity improved from 20/400 to 20/100 at 1 month postop. Best corrected visual acuity improved from 20/80 to 20/50.
Postop corneal thickness was 650-µm with an overall loss of 10% of the endothelial cells.
Advancements in technology will allow surgeons to avoid the first step of removing a disc, Dr. Carriazo said.
"In the future, with a femtosecond laser, we can create a pocket and remove just the stroma and introduce a normal stroma," Dr. Carriazo said.