A multicenter retrospective analysis found that corneal tissue addition keratoplasty (CTAK) was associated with improved visual acuity and corneal regularization at 1 month in patients with corneal ectatic disorders. The study included 63 consecutive eyes that underwent CTAK between March 20, 2023, and December 29, 2025. Data were pooled from 4 clinical sites: Cleveland Eye Clinic, Wills Eye Hospital, Vance Thompson Vision, and Advanced Vision Care. The study authors were Brandon Ayres, MD; William F. Wiley, MD; John Berdahl, MD; and Nicole Fram, MD.

“For decades, keratoconus treatment has largely focused on slowing disease progression or compensating for irregular vision. Corneal tissue addition keratoplasty introduces a new paradigm by allowing surgeons to address corneal irregularity with a level of customization and precision that was previously unattainable,” study coauthor Dr. Ayres told Ophthalmology Management. “What's especially encouraging is that as experience with the procedure grows, we're seeing consistent outcomes across multiple centers and surgeons, giving us greater confidence in its reproducibility and clinical impact. These study findings reinforce CTAK's potential as an important tissue-preserving option in the evolving management of keratoconus."

At 1 month, uncorrected visual acuity improved from a mean of 1.04 logMAR before surgery to 0.49 logMAR, a mean change of -0.55 logMAR (95% CI, -0.73 to -0.37; n=30). Best-corrected visual acuity improved from 0.40 logMAR to 0.16 logMAR, a mean change of -0.23 logMAR (95% CI, -0.31 to -0.16; n=53). Mean keratometry decreased from 51.94 D preoperatively to 49.90 D at 1 month, representing 2.04 D of corneal flattening (95% CI, -3.12 to -0.96; n=50). Manifest refraction spherical equivalent shifted from -4.66 D to -2.10 D, a mean change of 2.56 D (95% CI, 1.36 to 3.76; n=43). Anterior corneal cylinder measured with Pentacam tomography did not change significantly, decreasing from 4.53 D to 4.40 D (mean change, -0.13 D; 95% CI, -0.88 to 0.62; n=48).

The investigators concluded that the multicenter findings demonstrate promising short-term visual and refractive outcomes following CTAK and support further evaluation of the tissue-preserving procedure for corneal ectatic disorders. Longer-term follow-up will be needed to assess the durability of the visual and refractive changes.

"It's exciting to see CTAK gaining momentum across the corneal community as more surgeons experience its potential firsthand,” CEO of CorneaGen Bernie Iliakis told OM. “Progress like this is only possible through collaboration, and we're grateful to partner with clinicians, researchers, and industry innovators who share a commitment to advancing patient care.”