Awwad Shady T, Jacob Soosan, Asfar Karen E, Assaf Jad F, Fogla Rajesh, Bteich Yara, Jurdi Nawwaf
Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon.
Dr. Agarwal's Eye Hospital, Chennai, India.
Cornea. 2025 Jul 22. doi: 10.1097/ICO.0000000000003941.
The purpose of this study was to describe a new technique for rapid extensive dehydration of corneal allogeneic intrastromal ring segments (CAIRSs) using thermal energy conduction to facilitate implantation.
Donor corneas were trephined into annular stromal rings, halved, and placed into a titanium mold with a semicircular recess. The mold was positioned on a sterile polyethylene drape covering a USB-powered cup heater with a tempered glass surface (Tangxi, Guangzhou, China, set to 55°C). Segments were covered with a 1 oz plastic medicine cup (Amsino International, Pomona, CA) for 5 minutes, after which their temperature was monitored using a laser thermometer and found to be 47.5 ± 0.8°C. Resulting segments were rigid and maintained their arc shape, allowing for forceps-only insertion into femtosecond laser-created stromal tunnels. Insertion time (from tunnel creation to segment ironing) was measured through surgical video. Segment dimensions were assessed using optical coherence tomography at 1 week, 1 month, and 3 months. Four dehydrated segments underwent histopathologic analysis.
A total of 33 eyes from 29 patients underwent single-segment CAIRS implantation using the thermal dehydration technique. The mean combined insertion and repositioning time was 86 ± 19 seconds. Optical coherence tomography showed segment thickness and width of 498 ± 72 μm and 1119 ± 175 μm at 1 week, and 443 ± 67 μm and 1292 ± 220 μm at 3 months. Histopathology revealed preserved stromal architecture without evidence of thermal damage.
Controlled thermal energy conduction significantly reduces CAIRS dehydration time and simplifies insertion, enhancing surgical efficiency while preserving tissue integrity.
本研究的目的是描述一种利用热能传导对角膜同种异体基质内环片（CAIRS）进行快速广泛脱水的新技术，以促进植入。
将供体角膜切成环形基质环，切成两半，放入带有半圆形凹槽的钛模具中。将模具放置在覆盖有带钢化玻璃表面的USB供电杯式加热器（中国广州塘西，设置为55°C）的无菌聚乙烯布上。用一个1盎司的塑料药杯（美国加利福尼亚州波莫纳的Amsino International公司）覆盖切片5分钟，之后用激光温度计监测其温度，发现为47.5±0.8°C。所得切片变硬并保持其弧形，允许仅用镊子插入飞秒激光创建的基质隧道中。通过手术视频测量插入时间（从隧道创建到切片熨烫）。在1周、1个月和3个月时使用光学相干断层扫描评估切片尺寸。对四个脱水切片进行组织病理学分析。
29例患者的33只眼使用热脱水技术进行了单切片CAIRS植入。插入和重新定位的平均总时间为86±19秒。光学相干断层扫描显示，1周时切片厚度和宽度分别为498±72μm和1119±175μm，3个月时为443±67μm和1292±220μm。组织病理学显示基质结构保存完好，无热损伤迹象。
可控的热能传导显著缩短了CAIRS的脱水时间并简化了插入过程，提高了手术效率，同时保持了组织完整性。
