ESCRS - PO246 - Fresh Lenticule Intrastromal Implantation For Keratoconus Using Smile - A Long-Term Follow-Up Study: Ultrastructural Analysis By Transmission Electron Microscopy.

Fresh Lenticule Intrastromal Implantation For Keratoconus Using Smile - A Long-Term Follow-Up Study: Ultrastructural Analysis By Transmission Electron Microscopy.

Published 2022 - 40th Congress of the ESCRS

Reference: PO246 | Type: Free paper | DOI: 10.82333/kt5k-gb23

Authors: Faruk Semiz* 1 , anita syla lokaj 1 , njomza hima musa 1 , ceren ece Semiz 2 , zekeriya alp demirsoy 3 , Olcay Semiz 1

1ophtalmoloji,Eye Hospital,Prishtinë,Kosova,Prishtinë,Albania, 2Gazi University of Medicine,medicine faculte,ankara,Türkiye, 3Yeditepe University of Medicine,medicine faculte,istanbul,Türkiye

Purpose

To investigate new intrastromal histological structures that develop after myopic human lenticular implantation in keratoconus (KC) with femtosecond laser-involved small incision lenticule extraction (SMILE) surgery using transmission electron microscopy. 

Setting

Department of Ophthalmology, Eye Hospital, Prishtina, Kosova; 

Methods

Sixty eyes with advanced KC indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants were placed in all the eyes through SMILE surgery. Pieces of lenticular implants were extracted from normal corneal stroma, untreated KC, and treated KC following one, two, and three years of surgery. These five samples were examined under the electron microscope and compared. 

Results

Disorganized and thinned collagen fibers were observed in the stroma with degenerative stromal cells (telocyte [TC] -like cells and keratocytes) In the KC cornea. Apoptotic bodies and cell debris were easily observed near the disorganized fibers. In contrast, the corneal stroma of the control and treatment groups demonstrated well-organized parallel lamellar structures. Healthy keratocytes and TC- like cells were observed in samples obtained one, two, and three years after the lenticular implantation. Thus, TCs may be activated by appropriate stimuli, such as stem cells and be involved in stromal regeneration. 

Conclusions

Fresh lenticule intrastromal implantation is a safe, economical, and reliable technique that leads to increased corneal thickness, improved visual acuity, and the regeneration of healthy keratocytes and telocytes that are involved in stromal regeneration.
Fresh lenticule intrastromal implantation is a safe, economical, and reliable technique that leads to increased corneal thickness, improved visual acuity, and the regeneration of healthy keratocytes and telocytes that are involved in stromal regeneration.