To study the Outcomes of Intrastromal keratoplasty withBiosynthetic corneas Versus Biolenticules from donor corneas in cases of Keratoconus

Written informed consent will be taken from the patient. A detailed history and clinical examination will be done according to the above-mentioned parameters which will include visual acuity testing of both uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) measured using Snellen’s Chart. A detailed slit lamp examination will be done by an expert cornea specialist, a dilated fundoscopy to rule out any coexistent ocular disorders, non-contact Tonometry for Intra Ocular Pressure measurement and Central Corneal Thickness will also be done. High-Definition Anterior segment OCT, optical biomechanics and corneal wavefront aberrometry will be performed. A single surgeon, Prof. Namrata Sharma, will be performing all the surgeries under topical anesthesia. Under topical anesthesia, a corneal intrastromal pocket will be created using Femtosecond LASER system which will be extended by 0.75 to 1.0mm more than the base of cone of keratoconus cornea. Under microscope visualization intrastromal pocket will be opened using blunt lamellar dissection. Next, the biosynthetic cornea will be trephined using handheld trephine to 0.5mm oversize the base of the cone and will be placed in the intrastromal pocket. Entry wound will then be sealed with the help of fibrin glue. The patient will be evaluated at day 1, 1 week, 1 month and 3 months for visual acuity (uncorrected distance visual acuity, corrected distance visual acuity), Intraocular pressure by Non-contact Tonometry, Slit lamp bio microscopic examination, Fundus examination, High-Definition Anterior Segment Optical Coherence Tomography, corneal biomechanics and Tomography.