Reuse Of Customized Autologous Small-Incision Lenticule Extraction-Derived Lenticles For Presbyopia Correction

To explore the feasibility of excimer laser customized autologous small-incision lenticule extraction (SMILE)-derived lenticule implantation for correcting presbyopia.

Eye and ENT Hospital, Fudan University

Fresh SMILE-derived lenticules were laser-ablated to obtain microlenticules. Ex vivo lenticule microstructure and morphology were assessed. Six rabbit and two human autologous microlenticules were implanted in the contralateral eyes of rabbits and the non-dominant eye of patients with presbyopia, respectively. Visual acuity, manifest refraction, corneal topography, and optical coherence tomography images were examined one month, three months, and one year postoperatively. 

All lenticules were reshaped to approximately 1-mm in diameter. Customized rabbit microlenticules increased central corneal curvature and thickness. One year after microlenticule implantation, the uncorrected near visual acuity (UNVA) in the non-dominant eye of patients with presbyopia improved significantly. All patients achieved a binocular uncorrected distance visual acuity of 20/20 and a UNVA of 20/25. All microlenticules were transparent and well-centered without haze or rejection. The topography showed a central area of prolateness corresponding to the microlenticules. All patients were satisfied with the visual quality, and no complaints of glare or halos were reported.

This pilot study demonstrated the safety and efficacy of autologous SMILE-derived microlenticules customized with an excimer laser for presbyopia correction; however, its long-term outcomes require further investigation.