Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients

Keratoconus is one of the topical problems in modern ophthalmology. Among the currently used treatment methods is intralamellar keratoplasty that utilizes allomaterials or homotransplants. The surgery technique has obvious advantages over penetrating and deep anterior lamellar keratoplasty. There is...

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Main Authors: G. A. Osipyan, Kh. Khrayst
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2019-06-01
Series:Oftalʹmologiâ
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Online Access:https://www.ophthalmojournal.com/opht/article/view/950
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author G. A. Osipyan
Kh. Khrayst
author_facet G. A. Osipyan
Kh. Khrayst
author_sort G. A. Osipyan
collection DOAJ
description Keratoconus is one of the topical problems in modern ophthalmology. Among the currently used treatment methods is intralamellar keratoplasty that utilizes allomaterials or homotransplants. The surgery technique has obvious advantages over penetrating and deep anterior lamellar keratoplasty. There is no risk of tissue incompatibility, the recovery period is shorter, and prolonged use of corticosteroids is not necessary. In recent years, technological development has made the application of femtosecond laser a standard procedure for various surgical interventions on the cornea, particularly for creation of intrastromal tunnels and corneal bags. This article presents an analysis of the modern literature data about different intralamellar keratoplasty techniques for treatment of keratoconus. The described techniques show its great clinical possibilities, especially the intrastromal keratoplasty variant with implantation of biological tissues. One of such techniques was developed and tried by a group of specialists at Research Institute of Eye Diseases in 2014. It involves recovery of corneal thickness in the ectatic area by intralamellar transplantation of a layered transplant of adequate size, which acts as a bandage. The surgery simultaneously affects the stabilization action, corrects refractive errors and eliminates the structural changes; it was accordingly named bandage therapeutic-optical keratoplasty (BTOK). The indication for its usage is progressing keratoconus in stage II–III patients. Among the described outcomes are cease of the disease progression in long-term follow-up, improvement of corrected and uncorrected visual acuity. The foreign analogue of the technique is Corneal Allogenic Intrastromal Ring Segments (CAIRS) by Jacob S. et al. His study included 20 patients with stages I to IV keratoconus; all patients undergone corneal cross-linking as the first stage, then they had CAIRS implanted into the intrastromal tunnels prepared with femtosecond laser. In both methods, the authors point at the improvement of corrected and uncorrected visual acuity. None of the patients had implant dislocation or keratoconus progression during the follow-up period.
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spelling doaj-art-38d024138d1d4c5e92c7449292c5b4aa2025-08-20T03:38:16ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452019-06-0116216917310.18008/1816-5095-2019-2-169-173534Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus PatientsG. A. Osipyan0Kh. Khrayst1Research Institute of Eye DiseasesResearch Institute of Eye DiseasesKeratoconus is one of the topical problems in modern ophthalmology. Among the currently used treatment methods is intralamellar keratoplasty that utilizes allomaterials or homotransplants. The surgery technique has obvious advantages over penetrating and deep anterior lamellar keratoplasty. There is no risk of tissue incompatibility, the recovery period is shorter, and prolonged use of corticosteroids is not necessary. In recent years, technological development has made the application of femtosecond laser a standard procedure for various surgical interventions on the cornea, particularly for creation of intrastromal tunnels and corneal bags. This article presents an analysis of the modern literature data about different intralamellar keratoplasty techniques for treatment of keratoconus. The described techniques show its great clinical possibilities, especially the intrastromal keratoplasty variant with implantation of biological tissues. One of such techniques was developed and tried by a group of specialists at Research Institute of Eye Diseases in 2014. It involves recovery of corneal thickness in the ectatic area by intralamellar transplantation of a layered transplant of adequate size, which acts as a bandage. The surgery simultaneously affects the stabilization action, corrects refractive errors and eliminates the structural changes; it was accordingly named bandage therapeutic-optical keratoplasty (BTOK). The indication for its usage is progressing keratoconus in stage II–III patients. Among the described outcomes are cease of the disease progression in long-term follow-up, improvement of corrected and uncorrected visual acuity. The foreign analogue of the technique is Corneal Allogenic Intrastromal Ring Segments (CAIRS) by Jacob S. et al. His study included 20 patients with stages I to IV keratoconus; all patients undergone corneal cross-linking as the first stage, then they had CAIRS implanted into the intrastromal tunnels prepared with femtosecond laser. In both methods, the authors point at the improvement of corrected and uncorrected visual acuity. None of the patients had implant dislocation or keratoconus progression during the follow-up period.https://www.ophthalmojournal.com/opht/article/view/950keratoconusintralamellar keratoplastybandage therapeutic-optical keratoplastyimplantation of corneal intrastromal ring segments
spellingShingle G. A. Osipyan
Kh. Khrayst
Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
Oftalʹmologiâ
keratoconus
intralamellar keratoplasty
bandage therapeutic-optical keratoplasty
implantation of corneal intrastromal ring segments
title Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
title_full Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
title_fullStr Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
title_full_unstemmed Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
title_short Possibilities of Intralamellar Keratoplasty in Rehabilitation of Keratoconus Patients
title_sort possibilities of intralamellar keratoplasty in rehabilitation of keratoconus patients
topic keratoconus
intralamellar keratoplasty
bandage therapeutic-optical keratoplasty
implantation of corneal intrastromal ring segments
url https://www.ophthalmojournal.com/opht/article/view/950
work_keys_str_mv AT gaosipyan possibilitiesofintralamellarkeratoplastyinrehabilitationofkeratoconuspatients
AT khkhrayst possibilitiesofintralamellarkeratoplastyinrehabilitationofkeratoconuspatients