ESCRS - P130 - CORNEAL LENTICULE IMPLANTATION CRITERIA FOR PROGRESSIVE CORNEAL DISEASES USING SMILE MODULE

CORNEAL LENTICULE IMPLANTATION CRITERIA FOR PROGRESSIVE CORNEAL DISEASES USING SMILE MODULE

Published 2023 - 27th ESCRS Winter Meeting

Reference: P130 | Type: Presented Poster & Poster Submission | DOI: 10.82333/vwbp-5z93

Authors: Faruk Semiz* 1 , Anita syla Lokaj 1 , Njomza Hima musa 1 , Gokce Idil Semiz 2 , Zekeriya Alp Demirsoy 3 , Ceren Ece Semiz 4

1Ophthalmology,Eye Hospital,Prishtina,Kosovo, 2Medical Faculty,Bahcesehir University,Istanbul,Türkiye, 3Medical Faculty,Yedi Tepe University,Istanbul,Türkiye, 4Medical Faculty,Gazi University,Ankara,Türkiye

Purpose

Our study aims to calculate the thickness of the fresh lenticule depending on the corneal thickness of patients with advanced keratoconus and to investigate it after implantation with the SMILE Module.

Setting

Eye Hospital,Pristina,Kosovo

Methods

Sixty eyes with advanced keratoconus indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea. The implantation of fresh lenticule thickness depends on keratoconus corneal thickness, for example, if the corneal central thickness is 300-400 μm we implanted 1/2 stroma if CCT is 400 μm or more we implanted 1/3 stroma For Example: if CCTis 300 μm we implanted 150 μm (becoming 450 μm) we added more stroma due to more live keratocytes, stromal stem cells, and Telocytes, aiming to overcome dead and non-functional keratocytes.

Results

The preoperative CCT increased from 338.35 ± 11.24 µm (range: 300 to 349 µm) to 474.35 ± 4.31 µm (range: 469 to 482 µm) (P < .001), the preoperative CCT increased from 365 ± 6.91 µm (range: 353 to 377 µm) to 481.95 ± 6.00 µm (range: 473 to 491 µm) (P < .001),  the preoperative CCT increased from 399 ± 13.29 µm (range: 381 to 419 µm) to 482.10 ± 8.12 µm (range: 470 to 502 µm (P < .001).

Conclusion

We have concluded that every biomechanical instability of corneal stroma function(abnormal increase in collagen activity, decrease in proteinase inhibitors, excessive premature keratocyte apoptosis) describes the role of stroma in corneal thickness. As we have seen, when the thickness of the fresh lenticle is calculated and implanted depending on the corneal thickness of the patients with advanced keratoconus, both the corneal thickness increases and the corneal regeneration  since it contains enough live stem cells, keratocytes, and telocytes.
NCT04848740

We have concluded that every biomechanical instability of corneal stroma function(abnormal increase in collagen activity, decrease in proteinase inhibitors, excessive premature keratocyte apoptosis) describes the role of stroma in corneal thickness. As we have seen, when the thickness of the fresh lenticule is calculated and implanted depending on the corneal thickness of the patients with advanced keratoconus, both the corneal thickness increases and the corneal regeneration  since it contains enough live stem cells, keratocytes, and telocytes.

NCT04848740

Key Words: live stem cells, keratocytes,  telocytes, Fresh Lenticular thickness