Customized Stromal Lenticule Implantation for Keratoconus
Azad Sanginabadi
Iran University of Medical Sciences
: Int J Ophthalmic Pathol
Abstract
PURPOSE: To investigate the potential benefit of keratoconus surgery using customized corneal stromal donor lenticules obtained from myopic small incision lenticule extraction (SMILE) surgery by femtosecond laser. METHODS: In this prospective, consecutive, non-comparative series of cases, 22 lenticules were obtained from 22 myopic patients who had SMILE with a lenticule central thickness of greater than 110 μm. The lenticules were implanted in 22 eyes with advanced keratoconus. The lenticules were customized for the purpose of the implantation with either a simple neck¬lace or necklace-with-ring shape (compound form) depending on the corneal thickness and corneal topography configura¬tion of the implanted keratoconic eyes. The lenticules were implanted into a 9.5-mm corneal lamellar pocket created by the femtosecond laser. Changes in densitometry, thickness, confocal microscopy, corrected distance visual acuity (CDVA), and endothelial cell density were investigated. RESULTS: Intrastromal lenticule implantation was success¬fully performed in all cases without any complication. Corne¬al thickness showed a mean enhancement of 100.4 μm at the thinnest point. On biomicroscopy, all corneas were clear at 1 year postoperatively and there was a significant improvement in corneal densitometry during the entire follow-up period. Confocal biomicroscopy showed collagen reactivation with¬out any inflammatory features caused by the implanted fresh lenticules. CDVA improved from 0.70 to 0.49 logMAR (P = .001) and keratometry decreased from 54.68 ± 2.77 to 51.95 ± 2.21 diopters (P = .006). CONCLUSIONS: Customized SMILE lenticule implantation by femtosecond laser proved to be feasible, resulting in an improvement in vision, topography, and refraction in the im¬planted eyes.
Biography
Azad Sanginabadi has completed his MSc at the age of 25 years from Iran University of Medical Sciences.He is Founder and director of the International Health Tourism Company "cheshmpezeshkan. He has published more than 18 papers in reputed journals and has been serving as an editorial board member of repute.
