A New Pre-descemetic Corneal Ring (Neoring) in Deep Anterior Lamellar Keratoplasty for Moderate-Advanced Keratoconus: A Pilot 2-Year Long-Term Follow-Up Study

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Alfonso Bartolozzi, Belén and Lisa Fernández, Carlos and Fernández-Vega Cueto, Luis and Madrid Costa, David and Alfonso Sánchez, José F. (2021) A New Pre-descemetic Corneal Ring (Neoring) in Deep Anterior Lamellar Keratoplasty for Moderate-Advanced Keratoconus: A Pilot 2-Year Long-Term Follow-Up Study. Frontiers in Medicine, 8 . art. 771395. ISSN 2296-858X

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Official URL: https://doi.org/ 10.3389/fmed.2021.771365



Abstract

Purpose: To assess the outcomes of implanting a new polymethylmethacrylate (PMMA) ring (Neoring; AJL Ophthalmic) in pre-descemet deep anterior lamellar keratoplasty (PD-DALK) procedure for moderate-advanced keratoconus.
Methods: This prospective study included 10 eyes of 10 patients with moderate-advanced keratoconus who underwent PD-DALK with Neoring implantation. Neoring was implanted in a pre-descemetic pocket. The post-operative examination included refraction, corrected distance visual acuity (CDVA), corneal tomography, and endothelial cell density (ECD). The root mean squares (RMSs) for coma-like aberrations and spherical aberration were evaluated for a pupil size of 4.5mm. The junctional graft (Tg) and host (Th) thicknesses were measured. The post-operative follow-up was 24 months.
Results: Post-operative CDVA was 0.82 ± 0.14 (decimal scale), 100% of the eyes achieved a CDVA of 0.7 (decimal scale). The refractive cylinder was −2.86 ± 1.65 2-years after surgery. No eyes had a post-operative refractive cylinder ≥5.00 D and in five eyes (50%), it was ≤2.50 D. At the last visit, the mean keratometry was 45.64 ± 1.96 D, the RMS for coma-like aberrations was 0.30 ± 0.15μm and spherical aberration was 0.22 ± 0.09. The mean ECD remains without changes over the follow-up (P = 0.07). At the last visit, Tg and Th were 679.9 ± 39.0 and 634.8 ± 41.2μm, respectively. The thickness of the complex (host-Neoring) was 740.6 ± 35.6μm. In all cases, this thickness was thicker than Tg.
Conclusion: The results of this study suggest that PD-DALK along Neoring implantation is a viable, effective, and safe option to optimize the post-operative results for moderate-severe keratoconus


Item Type:Article
Additional Information:

Received: 06 September 2021; Accepted: 04 October 2021;Published: 04 November 2021

Uncontrolled Keywords:Corneal transplant, Deep anterior lamellar keratoplasty (DALK), Visual outcomes, Refractive outcomes,Keratoconus
Subjects:Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Optical materials
ID Code:69201
Deposited On:25 Feb 2022 11:21
Last Modified:25 Feb 2022 11:21

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