Corneal Stroma Densitometry Evolution In A Clinical Model Of Cellular Therapy For Advanced Keratoconus

To report the corneal stromal densitometry (CD) evolution studied by Scheimpflug tomography, anterior segment optical coherence tomography (AS-OCT), and confocal microscopy changes, in keratoconus patients included in a clinical experience of advanced cell therapy using autologous humans adipose-derived adult stem cells (ADASCs), and corneal decellularized or ADASCs-recellularized human donor corneal laminas in advanced keratoconus.

Division of Ophthalmology, Miguel Hernandez University, Alicante-Spain. Vissum Instituto Oftalmologico (grupo Miranza), Alicante- Spain. Lebanese University, Doctoral School of Sciences and Technology, Lebanon. And Optica General, Saida-Lebanon.

Interventional prospective, consecutive, randomized, comparative series of cases. Fourteen keratoconic patients were randomly distributed into three groups for three types of surgical interventions: group 1 (G-1), autologous ADASCs implantation (n = 5); group 2 (G-2), decellularized human corneal stroma (n = 5); and, group 3 (G-3), autologous ADASCs + decellularized human corneal stroma (n = 4). Participants were assessed with Scheimpflug-based Oculus Pentacam CD module, AS-OCT (Visante, Carl Zeiss), and confocal microscopy (HRT3 RCM Heidelberg).

The central and total CD were statistically significantly higher in G-2 compared with G-1, and G-3 compared with G-1 at the studied annular zones centered on the corneal apex (0-2mm, 2-6mm, and 6-10mm). There was statistical significance higher in G-3 compared with G-2 at the central corneal stroma at (0-2mm, 2-6mm). The confocal microscopy findings, as well as the AS-OCT reflected the densitometry changes.

The intrastromal implantation of ADASCs produced very subtle changes in CD at the level of the central corneal stroma. However, the intrastromal implantation of decellularized corneal laminas increases it slightly, but with lower values than the implantation of recellularized laminas with ADASCs.