Comparison of Visual and Topographic Outcomes Between Deep Anterior Lamellar Keratoplasty and Corneal Allogenic Intrastromal Ring Segment Implantation in Advanced Keratoconus: A Preliminary Study


Kara N., Sarsu Kocaaslan E., Görmez G. N., Tos B., Aksoy B. E., Arslan E., ...Daha Fazla

Cornea, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1097/ico.0000000000004136
  • Dergi Adı: Cornea
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Anahtar Kelimeler: corneal allogenic intrastromal ring segment, deep anterior lamellar keratoplasty, keratoconus
  • Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet

Özet

Purpose: – To compare the visual, refractive, and topographic outcomes of deep anterior lamellar keratoplasty (DALK) and Corneal Allogenic Intrastromal Ring Segment (CAIRS) implantation in eyes with advanced keratoconus.Methods: – This retrospective comparative study included 52 eyes of 52 patients with advanced keratoconus (Kmax > 58.0 D along with poor contact lens tolerance and inadequate spectacle-corrected distance visual acuity) who underwent either DALK (n = 26) or CAIRS implantation (n = 26). Preoperative and postoperative uncorrected and best-corrected visual acuity (UCVA, BCVA), spherical equivalent, keratometric values, and corneal higher-order aberrations were analyzed. All patients completed a minimum follow-up of 6 months after CAIRS implantation or 6 months after suture removal after DALK.Results: – Both procedures resulted in significant improvements in UCVA, BCVA, spherical equivalent, and keratometric values (all P < 0.001). Postoperative BCVA was significantly better in the DALK group (P = 0.027), whereas postoperative UCVA, refractive parameters, and keratometric measurements were comparable between groups (all P > 0.05). No significant differences in postoperative aberration parameters were detected between groups.Conclusions: – This study demonstrated that both CAIRS and DALK resulted in significant improvements in visual acuity, refractive outcomes, keratometric values, and aberrometric parameters in advanced keratoconus. CAIRS may have a role as an intermediate option in carefully selected cases before keratoplasty. Larger prospective studies with long-term follow-up are warranted.