Method of corneal transplantation or corneal inlay implantation with cross-linking
A method of corneal implantation with cross-linking is disclosed herein. In one or more embodiments, the method includes the steps of: (i) cutting a circular implant from a donor cornea; (ii) cutting the circular implant into a plurality of constituent pieces; (iii) forming a small incision in a recipient cornea of an eye of a patient; (iv) forming a pocket in the recipient cornea of the eye of the patient, the pocket being accessible through the small incision in the recipient cornea, and the pocket being bounded entirely by stromal tissue of the cornea; and (v) inserting each of the plurality of constituent pieces of the implant into the pocket of the recipient cornea via the small incision, wherein the implant is cross-linked so as to prevent an immune response to the implant and/or rejection of the implant by the patient.
1. A method of corneal implantation with cross-linking, said method comprising the steps of:
cutting a circular implant from a donor cornea;
cutting the circular implant into a plurality of constituent pieces;
forming a small incision in a recipient cornea of an eye of a patient;
forming a pocket in the recipient cornea of the eye of the patient, the pocket being accessible through the small incision in the recipient cornea, and the pocket being bounded entirely by stromal tissue of the cornea; and
inserting each of the plurality of constituent pieces of the implant into the pocket of the recipient cornea via the small incision, wherein the implant is cross-linked so as to prevent an immune response to the implant and/or rejection of the implant by the patient.
2. The method according to claim 1 , wherein, prior to cutting the circular implant into the plurality of constituent pieces, the method further comprises the step of:
applying laser energy to the circular implant using an excimer laser so as to modify the refractive power of the circular implant while being monitored using a Shack-Hartmann wavefront system so as to achieve a desired refractive power for the circular implant.
3. The method according to claim 1 , wherein the step of cutting a circular implant from a donor cornea comprises cutting the circular implant from the donor cornea using a circular trephine, and wherein the method further comprises the steps of:
removing the corneal epithelium and corneal endothelial cells from the circular implant; and
cutting the circular implant into two circular disks using a keratome or a femtosecond laser, the thickness of the two circular disks being between 50 microns and 200 microns, a first one of the two circular disks having an anterior surface formed by the Bowman's membrane and a posterior surface formed by the stroma, and a second one of the two circular disks having an anterior surface formed by the stroma and a posterior surface formed by the Descemet's membrane.
4. The method according to claim 3 , wherein, after the cutting of the circular implant into the two circular disks, the method further comprises the steps of:
soaking the two circular disks in a cross-linking solution that includes a photosensitizer; and
irradiating the two circular disks so as to activate cross-linkers in the two circular disks, and thereby cross-link the two circular disks to prevent an immune response to the implant and/or rejection of the implant by the patient.
5. The method according to claim 4 , wherein the photosensitizer of the cross-linking solution comprises nanoparticles of riboflavin, and wherein the step of irradiating the two circular disks comprises irradiating the two circular disks with ultraviolet light either prior to insertion into the pocket or after insertion into the pocket.
6. The method according to claim 5 , wherein the step of cutting the circular implant into a plurality of constituent pieces further comprises cutting the first one and/or second one of the two circular disks into a plurality of circular pieces or sector-shaped pieces using a knife after the two circular disks have been cross-linked.