Industry

Best CTAK candidates have worse visual acuity, central cones

Healio Optometry7h ago1 min read

WASHINGTON — The best candidates for corneal tissue addition keratoplasty fit certain topographical and visual criteria, according to a speaker at Cornea Day at the American Society of Cataract and Refractive Surgery meeting.Steven Greenstein, MD, of the Cornea & Laser Eye Institute, said surgeons initially performed corneal tissue addition keratoplasty (CTAK, CorneaGen) as a lamellar procedure, but it has transformed into a more personalized procedure.“We moved to a more visual-sparing technique,” he said. “Originally, we were putting full circumferential inlays into the cornea and

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AI Summary

Quick Take

The most effective candidates for corneal tissue addition keratoplasty (CTAK) are patients presenting with central cones and poorer baseline visual acuity. Recent refinements have transitioned the procedure from a standard lamellar approach using full circumferential inlays to a more personalized, visual-sparing technique.

Why It Matters

As the industry moves toward more customized treatments for corneal ectasia, CTAK represents a significant shift from traditional subtractive refractive surgery to additive tissue-based remodeling. Identifying that patients with more advanced central steepening benefit most allows surgeons to better triage keratoconus patients who may not be ideal candidates for cross-linking alone but aren't yet ready for a full transplant. This evolution toward 'visual-sparing' techniques reflects a broader trend in ophthalmology to minimize surgical footprints while maximizing functional outcomes.

Key Details

CTAK (CorneaGen) has evolved from a standard lamellar procedure into a highly personalized surgical intervention.
The procedure originally utilized full circumferential inlays, but has since moved toward techniques that better preserve the visual axis.
Optimal patient selection is now based on specific topographical criteria, specifically the presence of central cones.
Clinical data suggests that patients with worse initial visual acuity tend to be the best candidates for the procedure's reshaping effects.

Practice Implications

When screening keratoconus or ectasia patients for tissue addition, clinicians should prioritize those with central cone morphology and significant visual impairment. Topographical mapping is essential to determine if the patient's cone location aligns with the current personalized, visual-sparing CTAK protocols.

Who's Affected

Cornea SpecialistsRefractive SurgeonsOptometrists managing advanced keratoconus

Evidence StrengthModerate

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