ESCRS - POCOR444 - Study On The Role Of Human Corneal Stromal Cells Derived From Smile Lenticules In Corneal Stromal Opacity Repair

Study On The Role Of Human Corneal Stromal Cells Derived From Smile Lenticules In Corneal Stromal Opacity Repair

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR444 | Type: Free paper | DOI: 10.82333/1zbr-8140

Authors: Dr Yuexi Chen* 1 , Dr Jin Zhou 1 , Jiansu Chen 2 , Zheng Wang 3

1Aier Eye Hospital Group ,Chengdu,China, 2Aier Eye Hospital Group,Changsha,China, 3Aier Eye Hospital Group ,Guangzhou,China

Purpose

To establish optimal culture conditions for extracting human corneal stromal cells (hCSCs) from SMILE -Derived lenticules and to assess their therapeutic potential in corneal stromal opacity through in vitro reprogramming.

Setting

Corneal opacity and scarring are major causes of blindness, and current treatments mainly rely on corneal transplantation, which is limited by donor shortage and immune rejection. Corneal stromal stem cells (CSSCs) show great potential in inhibiting fibrosis and promoting stromal transparency, but their availability remains restricted. SMILE surgery produces a large number of stromal lenticules each year, providing a novel and sustainable cell source for therapy.

Methods

 The hCSCs were extracted from corneal stromal lenticules obtained through SMILE surgery. And then, these cells were cultured on a novel 3D spheroid culture platform with conditioned medium (CM) from induced pluripotent stem cells (iPSCs) to reprogram them and increase their stemness. A rabbit corneal stromal opacity model was created using concentrated sulfuric acid. Subsequently, intrastromal cell transplantation was performed with the assistance of femtosecond laser technology(VisuMax500, Zeiss). The transparency of the cornea, expression of fibrosis markers, and inflammatory responses following transplantation were assessed using slit-lamp photography, AS-OCT, corneal topography, and immunofluorescence staining of frozen sections.

Results

The hCSCs with good viability were successfully extracted from corneal stromal lenticules obtained through SMILE surgery. The iPS-conditioned medium (iPS-CM) and 3D cell cultureantly enhanced the stemness properties of these cells, with increased system-significant expression of pluripotency factors including OCT4, NANOG, SOX2, KLF4, and PAX6. Femtosecond laser-assisted transplantation successfully delivered hCSCs into the corneal stroma of rabbits. Postoperative follow-up showed reduced corneal opacity, restored corneal thickness, decreased expression of fibrosis markers (e.g., α-SMA), and no significant immune rejection in the cell transplantation group.

Conclusions

Stromal lenticules derived from SMILE surgery serve as a high-quality cell source for in vitro cultivation of corneal stromal cells. Following reprogramming, hCSCs exhibit promising safety and therapeutic efficacy in a rabbit model of corneal stromal opacity, thereby establishing a novel cellular therapeutic approach for clinical management of corneal opacification and scar tissue formation.