Intrastromal Allogenic Implantation for Corneal Re-shaping

The aim of this presentation is to highlight the growing interest in allogeneic intrastromal implantation techniques in the management of keratoconus. These techniques allow the corneal curvature to be reshaped by implanting a small fragment of corneal stroma from a donor. They have the advantage of being easy to perform and are free from rejection. Three main approaches are detailed: Bowman's layer transplantation appears useful in very advanced keratoconus cases with a Kmax greater than 70 D; allogenic intrastromal rings segments (CAIRS) induce corneal flattening proportional to their thickness; and lenticules from SMILE surgery show a more modest but promising effect. The optimal preservation of these grafts remains to be defined. Finally, other options such as porcine collagen implants are extending the therapeutic possibilities.
Pr Marc MURAINE (CHU Rouen)