Long-Term Results Of Fresh Lenticule Transplantation For The Treatment Of Herpetic Scarring

The purpose of this study is to investigate a novel surgical method for patients with stromal herpetic scarring. 

Eye Hospital, Prishtina, Kosovo

This study included 23 eyes from 23 patients (13 female, 10 male, aged 21–46 years) with herpetic corneal scarring. Stromal scar thickness was measured by optical coherence tomography (OCT), and scar removal was performed using femtosecond laser-assisted SMILE, followed by fresh lenticule transplantation to achieve a postoperative corneal thickness of at least 460 μm. Lenticule selection was based on individual corneal topography to optimize contour and stability. All patients were monitored for at least 3 years with regular assessments of UDVA, CDVA, slit-lamp examination, corneal topography, anterior segment OCT, and pachymetry to evaluate visual outcomes, corneal integrity, and graft integration.

All surgeries were uneventful without complications. No retransplantation was needed in the course of 3 years or longer and no recurrence was observed. There was a significant improvement in preoperative corrected distance visual acuity (CDVA), increasing from 0.88 ± 0.26 logMAR to 0.49 ± 0.08 logMAR (P < .001). The central corneal thickness (CCT) increased significantly from 448.35 ± 11.24 μm (range: 420–480 μm) preoperatively to 504.35 ± 10.31 μm (range: 480–555 μm) postoperatively (P < .001). Additionally, the Q value decreased from -0.39 ± 0.04 preoperatively to -0.67 ± 0.05 postoperatively.

Lenticule transplantation is a safe and effective treatment that enhances visual acuity by modifying the Q value while facilitating corneal stabilization and regeneration.