Study On The Reparative Effects Of Transplantation Of Decellularized And Lyophilized Human Corneal Stromal Lenticules Loaded With Nerve Growth Factor

This study aimed to develop a novel, reparative extracellular matrix (ECM) scaffold using corneal stromal lenticules derived from small incision lenticule extraction (SMILE) for corneal tissue repair after lenticule intrastromal keratoplasty through decellularization, lyophilization, and surface modification with oxidized heparin.

Corneal stromal lenticule transplantation can be utilized to treat a variety of ocular diseases such as keratoconus, hyperopia, and corneal perforations, yet current reuse of lenticules face limitations such as short preservation, strict storage requirements, and slow postoperative recovery. Therefore, there is a need to develop a corneal transplant material that is conducive to long-term preservation, exhibits good biocompatibility, and promotes the repair of corneal tissue.

Corneal stromal lenticules derived from SMILE surgeries were processed using decellularization and lyophilization to create a porous, natural ECM scaffold. The scaffold was further modified with oxidized heparin to enable charge-capture-based nerve growth factor (NGF) loading. The physicochemical properties, effects on cell growth, and the release time of NGF of the scaffold were evaluated in vitro. The safety of the ECM scaffold, its efficacy in promoting corneal morphological remodeling, and nerve regeneration were assessed using a rabbit corneal stromal lenticule transplantation model.

The decellularized and lyophilized lenticules showed low immunogenicity, retained collagen structure and transparency, and long-term storage efficiency for up to one year. Oxidized heparin-modified lenticlue could bind NGF through electrostatic interactions, creating a functional ECM scaffold capable of delivering NGF for 72 h in vitro and supporting corneal stromal cell growth. After implantation of the NGF-loaded lenticule into the rabbit corneal stromal pocket via small-incision lenticule intrastromal keratoplasty, the lenticules maintained transparency for up to 4 months, with no displacement or rejection, while promoting host cell integration and neural reinnervation in the transplanted corneal tissue.

The NGF-loaded decellularized and lyophilized corneal stromal lenticule demonstrates reparative efficacy in corneal lenticule intrastromal keratoplasty.