Intrastromal corneal ring in deep anterior lamellar keratoplasty

Abstract

We describe 2 patients with unilateral traumatic corneal leucoma and irregular astigmatism who were treated with deep anterior lamellar keratoplasty and a Krumeich intrastromal corneal ring (ICR) to prevent interface or donor stromal vascularization. The endothelial cell count was normal in the 2 eyes, and optical coherence tomography images of the corneas showed no alteration in the deep stroma and Descemet membrane. After 1 year, all the sutures were removed and a proliferation of vessels that stopped at the ring was seen. Both grafts were clear, and the ICR was located in the middle stroma; there was no sign of rejection, stromal clouding, or vascular ingrowth. Postoperative treatment was shorter than after lamellar keratoplasty. The ICR effectively prevented corneal blood vessel ingrowth in penetrating keratoplasty. It could also be applied to anterior lamellar keratoplasty in high-risk patients.