Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study
Purpose: To study the outcomes of femtosecond laser-assisted intrastromal negative meniscus lenticule implantation with accelerated corneal collagen crosslinking (FILAC) in advanced keratoconus. Methods: A prospective, interventional study evaluated the outcomes of FILAC in eyes with progressive ker...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | https://journals.lww.com/10.4103/IJO.IJO_2139_24 |
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| author | Rajesh Sinha Shahnaz Anjum Kartikeya Gupta Tushar Agarwal Namrata Sharma Sridevi Nair Shrishti Kapoor Jeewan S Titiyal |
| author_facet | Rajesh Sinha Shahnaz Anjum Kartikeya Gupta Tushar Agarwal Namrata Sharma Sridevi Nair Shrishti Kapoor Jeewan S Titiyal |
| author_sort | Rajesh Sinha |
| collection | DOAJ |
| description | Purpose:
To study the outcomes of femtosecond laser-assisted intrastromal negative meniscus lenticule implantation with accelerated corneal collagen crosslinking (FILAC) in advanced keratoconus.
Methods:
A prospective, interventional study evaluated the outcomes of FILAC in eyes with progressive keratoconus of Amsler-Krumeich stage 4 with thinnest pachymetry of 320–400 microns. A total of 10 eyes of 10 patients were enrolled. A negative meniscus allogenic stromal lenticule of 8.5 mm diameter was implanted into a corneal pocket created by a femtosecond laser at 150 microns depth and simultaneous accelerated corneal collagen crosslinking (CXL). Outcomes assessed 12 months after the procedure included uncorrected distance visual acuity (UDVA) and best-corrected visual acuity (BCVA), subjective refraction, and corneal topography changes.
Results:
Mean UDVA improved from baseline to 12 months follow-up (1.43 ± 0.39 vs. 1.32 ± 0.31 logMAR, P = 0.49). Four patients did not accept contact lenses preoperatively, whereas all patients were successfully fitted with semi-scleral contact lenses postoperatively with a mean BCVA of 0.47 ± 0.14 logMAR at 12 months. Mean corneal topographic values showed improvement from baseline to 12 months follow-up: K1 (58.44 ± 5.59 to 55.57 ± 5.68), K2 (63.35 ± 6.86 to 59.35 ± 7.1), Kmax (71.07 ± 7.95 to 66.29 ± 7.54) and astigmatism (4.89 ± 3.35 to 3.88 ± 2.35) (P > 0.05). The mean thinnest pachymetry improved significantly from baseline to 12 months follow-up (354.9 ± 28.52 vs. 462.5 ± 36.30 microns, P = 0.0001). There was a non-significant improvement in subjective refraction and aberrometry.
Conclusion:
This technique effectively halts disease progression and improves visual outcomes in advanced keratoconus. |
| format | Article |
| id | doaj-art-1494bc80b5704ba48a3bed4ca886defa |
| institution | Kabale University |
| issn | 0301-4738 1998-3689 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj-art-1494bc80b5704ba48a3bed4ca886defa2025-08-20T03:29:22ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-07-0173797497910.4103/IJO.IJO_2139_24Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional studyRajesh SinhaShahnaz AnjumKartikeya GuptaTushar AgarwalNamrata SharmaSridevi NairShrishti KapoorJeewan S TitiyalPurpose: To study the outcomes of femtosecond laser-assisted intrastromal negative meniscus lenticule implantation with accelerated corneal collagen crosslinking (FILAC) in advanced keratoconus. Methods: A prospective, interventional study evaluated the outcomes of FILAC in eyes with progressive keratoconus of Amsler-Krumeich stage 4 with thinnest pachymetry of 320–400 microns. A total of 10 eyes of 10 patients were enrolled. A negative meniscus allogenic stromal lenticule of 8.5 mm diameter was implanted into a corneal pocket created by a femtosecond laser at 150 microns depth and simultaneous accelerated corneal collagen crosslinking (CXL). Outcomes assessed 12 months after the procedure included uncorrected distance visual acuity (UDVA) and best-corrected visual acuity (BCVA), subjective refraction, and corneal topography changes. Results: Mean UDVA improved from baseline to 12 months follow-up (1.43 ± 0.39 vs. 1.32 ± 0.31 logMAR, P = 0.49). Four patients did not accept contact lenses preoperatively, whereas all patients were successfully fitted with semi-scleral contact lenses postoperatively with a mean BCVA of 0.47 ± 0.14 logMAR at 12 months. Mean corneal topographic values showed improvement from baseline to 12 months follow-up: K1 (58.44 ± 5.59 to 55.57 ± 5.68), K2 (63.35 ± 6.86 to 59.35 ± 7.1), Kmax (71.07 ± 7.95 to 66.29 ± 7.54) and astigmatism (4.89 ± 3.35 to 3.88 ± 2.35) (P > 0.05). The mean thinnest pachymetry improved significantly from baseline to 12 months follow-up (354.9 ± 28.52 vs. 462.5 ± 36.30 microns, P = 0.0001). There was a non-significant improvement in subjective refraction and aberrometry. Conclusion: This technique effectively halts disease progression and improves visual outcomes in advanced keratoconus.https://journals.lww.com/10.4103/IJO.IJO_2139_24crosslinkingfemtosecond laserintrastromal lenticulekeratoconusriboflavin |
| spellingShingle | Rajesh Sinha Shahnaz Anjum Kartikeya Gupta Tushar Agarwal Namrata Sharma Sridevi Nair Shrishti Kapoor Jeewan S Titiyal Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study Indian Journal of Ophthalmology crosslinking femtosecond laser intrastromal lenticule keratoconus riboflavin |
| title | Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study |
| title_full | Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study |
| title_fullStr | Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study |
| title_full_unstemmed | Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study |
| title_short | Femtosecond laser-assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking (FILAC) in advanced keratoconus in Indian eyes: A prospective interventional study |
| title_sort | femtosecond laser assisted corneal intrastromal negative meniscus lenticule implantation with accelerated collagen crosslinking filac in advanced keratoconus in indian eyes a prospective interventional study |
| topic | crosslinking femtosecond laser intrastromal lenticule keratoconus riboflavin |
| url | https://journals.lww.com/10.4103/IJO.IJO_2139_24 |
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