Long-Term Results Of Cryopreserved Allogenic Corneal Lenticule Of Hyperopic Smile For Post-Lasik Ectasia

To investigate the long-term safety, efficacy, and corneal changes after implanting cryopreserved allogeneic lenticule of hyperopic SMILE for post-LASIK corneal ectasia.

Fudan University Eye & ENT Hospital, China

In the prospective, interventional case series, 6 eyes from 6 patients with post-LASIK ectasia were included between 2015 and 2018. For the recipient eyes, flaps were opened and lifted. Lenticules with a mean cryopreserved time of 65 days (range: 7-240 days) extracted from the hyperopic SMILE donor were transferred onto the exposed stromal bed and the flap was repositioned. Patients were followed up regularly for 1-7 years. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, corneal topography, and optical coherence tomography were performed.

On the last visit, the safety and efficacy indices were 2.42±2.25 and 1.15±1.45, respectively. UDVA improved from 1.52±0.40 (LogMAR) preoperatively to 0.74±0.28 at the last visit. Two eyes (33%) gained one line of CDVA, three eyes (50%) gained two lines, and one eye (17%) gained three or more lines. Spherical equivalents decreased from -14.67±2.36 D to -8.75±4.03 D (P=0.02). Five eyes (83%) showed a decrease in anterior K values greater than 1.0 D. Mean anterior K values changed from 52.13±6.52 D to 49.48±7.25 D (P=0.01) while mean total corneal refractive power decreased from 51.98±6.25 D to 47.78±7.60 D (P=0.04). The thinnest corneal thickness increased from 359.2±39.3 μm to 401.7±53.4 μm (P=0.02).

Implanting a cryopreserved concave allogenic lenticule could be a viable alternative treatment for post-LASIK ectasia, although its refractive predictability requires further refinement.