To report the outcomes, side effects and complications of a modified corneal inlay from donor corneal tissue for management of keratoconus (KCN).

In this pilot study, six eyes from 6 patients who candidates for DALK surgery were selected for study. All inlays were implanted in the recipients’ cornea by femtosecond Laser-assisted procidure. A stromal pocket created at 75% of corneal depth. Different modifications were done on donor tissue disks including correction of refractive error (both sphere and cylinder) with T-CAT profile, correction of spherical equivalent, punching the disk center with 3 & 6 mm punch. Corneal cross-linking of the pocket, using frozen donor, using two full thickness segments with 160' arc and 2.5 mm diameter.

After sufficient explanation to the patients,all surgeries were performed under topical anesthesia as planned without reportable complications. In early postoperative follow up, none of the patient have pain and redness. Only significant problem in four patients was blurred vision due to implants edema.Implants were clear at 3M after surgery with fine opacity.At 6,9 and 12 M ,F .U visit all grafts remains clear,but the vision in 4eyes didn't satisfied due to different reasons.

Only acceptable and useful implantable donor cornea tissue for managing and reshaping of KCN is rings and segments that saves central 5-6 mm optical zones.