CAIRS shows more corneal flattening when performed before cross-linking
FRANKFURT, Germany — Corneal allogenic intrastromal ring segment implantation has more flattening effect on the cone when performed in corneas that have not previously undergone corneal cross-linking, according to a study.
“This is arguably due to the stiffening effect of prior CXL,” Burcu Yucekul, MD, said at the ESCRS winter meeting.
The retrospective study included 67 eyes with advanced keratoconus implanted with KeraNatural (VisionGift) sterile, decellularized allograft rings; 30 eyes had previously undergone the CXL procedure, and 37 eyes had not. All tomographic and refractive parameters were similar in the CXL and non-CXL groups.
Changes in spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), K1, K2, mean curvature (Kmean), maximum curvature and thinnest pachymetry were evaluated 6 months after the corneal allogenic intrastromal ring segment (CAIRS) procedure. Improvement in all parameters was seen in both groups, but CDVA, K1 and Kmean showed higher improvement in non-CXL eyes than in CXL eyes.
There is currently no consensus on the timing of combined refractive and CXL procedures, Yucekul said. However, a study by Coskunseven and colleagues reported better outcomes of intracorneal ring segment implantation followed by rather than preceded by CXL.
“CAIRS has a significant flattening effect on the cornea with or without cross-linked eyes. CAIRS has more of a flattening effect on eyes without CXL,” Yucekul said.
“Therefore, to achieve maximum flattening effect and improvement in CDVA, CAIRS surgery should be applied before CXL,” according to the study abstract.
Reference:
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Yucekul B, et al. Effect of corneal allograft intrastromal ring segment implantation in keratoconic eyes with and without prior corneal crosslinking. Presented at: ESCRS winter meeting; Feb. 15-18, 2024; Frankfurt, Germany.
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