Allogenic corneal tissue transplantation in substitution for extruded intracorneal rings: A case series

We describe a case series of four eyes of four keratoconus patients with extruded intracorneal ring segments (ICRS) in whom donor corneal tissue was used to substitute for the extruded ICRS in an attempt to preserve its effect. In all patients, the extruded intracorneal ring was removed through the exposed area. Donor corneal tissue (tailored to the size and shape of the ICRS) was inserted into the empty ICRS tunnel and fixed in place using 10-0 nylon sutures. At three months follow-up, all patients had a healed graft and displayed a stable Kmax, best corrected visual acuity (BCVA) and corneal topography comparable to the preoperative values. Replacing extruded intracorneal rings with donor tissue grafts in keratoconus patients appears to be a promising technique in preserving the effect of the corneal ring and possibly in treating primary keratoconus with donor tissue segments. Refinement of the technique, longer follow-up, and a larger study population is warranted.