Rapid Dehydration of Corneal Allogeneic Intrastromal Ring Segments (CAIRSs) by Thermal Energy Conduction and Heating to Facilitate Implantation.

PURPOSE: 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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Controlled thermal energy conduction significantly reduces CAIRS dehydration time and simplifies insertion, enhancing surgical efficiency while preserving tissue integrity.