A Fresh Approach Towards Keratoconus Treatments

To demonstrate an increase in vision and central corneal thickness after intrastromal fresh myopic lenticule implantation in advanced keratoconus with the SMiLE module. And to examine both the implanted lenticule with the immunofluorescence method and electron microscopy after lenticule implantation in patients with keratoconus

EYE HOSPITAL,PRISTINA,KOSOVO

Thirty-five eyes with advanced keratoconus indicated for corneal transplantation were included in this study. Fresh myopic lenticular implants(FML) were placed in all eyes through SMILE surgery. Lenticular implants were extracted from patients with myopic refractive errors of the cornea, Visual acuity, corneal topography, and anterior segment optical coherence tomography, immunofluorescence method, and electron microscopy were analyzed.

All patients were followed for five years and all patients tolerated the procedure well. No reaction,  no signs of allogeneic rejection were observed in any of the patients. The preoperative CDVA improved from 1.44 ± 0.31 logMAR to 0.44 ± 0.06 logMAR  (P < .001). The preoperative CCT increased from 335.35 ± 11.24 µm to 477.35 ± 4.31 µm  (P < .001). Pieces are taken from the lenticule 5 years after lenticular implantation were examined by immunofluorescence method and electron microscopy.Healthy keratocytes and telocytes cells were observed in samples obtained five years after lenticular implantation. Thus, telocytes cells may be activated by appropriate stimuli, such as stem cells, and be involved in stromal regeneration

FML implantation is a safe, economical (does not require laboratory support), and reliable technique. This study showed that FML contains living stem cells and keratocytes, therefore it initiates the regeneration of corneal tissue, which leads to increased corneal thickness, and improved visual acuity.

NCT04591587