Thirty-month results after the treatment of post-LASIK ectasia with allogenic lenticule addition and corneal cross-linking: a case report

Li, Meiyan; Yang, Dong; Zhao, Feng; Han, Tian; Li, Meng; Zhou, Xingtao; Ni, Katherine

doi:10.1186/s12886-018-0967-z

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…Corneal power and astigmatism did increase after lenticular implantation, but the authors hypothesize that this was due to the refractive error of the implanted lenticule (−2.75 DC, DC = diopters cylinder). This study was significant because it demonstrated 5 years of stability of the implanted lenticule, with no evidence of immunogenic rejection or regression of visual acuity in a patient with post-LASIK ectasia [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review

Moshirfar,

Stoakes,

Bruce

et al. 2023

Ophthalmol Ther

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Introduction Intrastromal lenticule implantation is a promising treatment option for corneal pathologies, from refractive error to ectasia. In this narrative review, we intend to feature up-to-date literature supporting the use of lenticular tissue, a compelling method that can be customized for a variety of applications, providing an additional source of donor tissue for treating corneal diseases. Methods We searched databases PubMed, Mendeley, and Scopus last accessed 10 May 2023, for literature on stromal lenticules and narrowed based on relevance. Review articles, animal studies, ex vivo studies, and book chapters were excluded, while assessable and relevant articles published in English were included. Results Storage methods from using fresh lenticules to dehydration have proven successful, with cryopreservation maintaining structure and cellular viability for up to 10 years. Successful use of lenticules for treatment of numerous pathologies including corneal ectasias, hyperopia, and presbyopia with additional insight into the treatment of corneal ulcers and perforations are highlighted in this narrative review. Conclusion Lenticular implantation is an innovative and advantageous treatment for various ocular pathologies, offering increased bioavailability, flexibility, and customization for patients. They can treat previously untreatable diseases and serve as a replacement for synthetic implants, with promising outcomes worldwide. Lenticular implantation has the potential to become a leading approach in ophthalmologic surgery. Further studies should aim to provide evidentiary support for a standardization of lenticule banking.

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Section: Resultsmentioning

confidence: 99%

Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review

Moshirfar,

Stoakes,

Bruce

et al. 2023

Ophthalmol Ther

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“…In our previous study ( Li et al, 2018 ), lenticule addition followed by ATE-CXL was performed on a patient with post-LASIK ectasia. Improved CDVA and stable corneal keratometry and elevation was observed at 30 months postoperatively; thus, lenticule addition prior to ATE-CXL was proven to be a potential treatment option for patients with keratectasia associated with a thin cornea.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of Accelerated Transepithelial Corneal Crosslinking for Post-LASIK Ectasia: A Pilot Prospective Observational Study

Tian

Zhang

Jian

et al. 2021

Front. Bioeng. Biotechnol.

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Background: Keratectasia after corneal refractive surgery is a rare but serious postoperative complication, and reports on accelerated transepithelial corneal crosslinking (ATE-CXL)-based treatment of patients with post-laser-assisted in situ keratomileusis (LASIK) ectasia are limited. Therefore, this study evaluated the long-term efficacy and safety of ATE-CXL for progressive post-LASIK ectasia.Methods: This prospective observational study was conducted at the Eye and ENT Hospital, Fudan University, Shanghai, China, and 25 eyes from 25 patients with post-LASIK ectasia undergoing ATE-CXL were examined. Clinical examinations were conducted preoperatively and postoperatively to assess parameters such as manifest refraction, corrected distance visual acuity (CDVA), endothelial cell density; keratometry, corneal thickness, posterior elevation and topometric indices were measured using Pentacam; sectoral pachymetry and epithelial thickness were evaluated using optical coherence tomography. A paired t-test, Wilcoxon rank-sum test, Kruskal-Wallis test, and repeated measures analysis of variance were used for statistical analysis.Results: Participants were examined for an average of 46 months. No severe complications occurred during or after ATE-CXL. CDVA improved from 0.25 ± 0.31 preoperatively to 0.15 ± 0.17 postoperatively (p = 0.011). Maximum keratometry decreased from 55.20 ± 8.33 D to 54.40 ± 7.98 D, with no statistical significance (p = 0.074), and the central corneal thickness increased from 414.92 ± 40.96 μm to 420.28 ± 44.78 μm (p = 0.047) at the final follow-up. Posterior elevation, pachymetry, and epithelial thickness remained stable (p > 0.05) throughout the follow-up. No significant differences were noted in topometric indices, except the central keratoconus index, which decreased significantly (p < 0.001) at the final follow-up.Conclusion: Improvements in CDVA and stabilization in corneal keratometry and posterior elevation after ATE-CXL were noted at the 46-months follow-up, demonstrating that ATE-CXL is a safe and effective treatment for progressive post-LASIK ectasia.

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“…We recommend investigating recellularized customized SMILEextracted lenticules (which combine the benefits of planar and negative meniscus-shaped lenticules) with mesenchymal stem cells in a large number of advanced keratoconus patients, as multiple studies have shown the feasibility of regenerating the corneal stroma using autologous adipose-derived adult stem cells [57,69,71] . Table 2 [49,[53][54][55][56][60][61]65,67,74] summarizes clinical studies investigating SMILE-extracted lenticule applications in corneal ectasia treatment. Patch Graft for Glaucoma Tube Implants Wang et al [41] compared the efficacy of SMILE-extracted lenticules and the sclera as patch graft to prevent glaucoma drainage tube exposure.…”

Section: Smile-extracted Lenticules In Ophthalmologymentioning

confidence: 99%

“…Since then, various animal models have shown the effectiveness and safety [53] Case series Post-LASIK ectasia 3 13 Safe surgical approach for the treatment of post-LASIK ectasia, especially for severe cases with cornea thickness less than 400 μm. Li et al (2018) [54,74]…”

Section: Corneal Tissue Engineering and Animal Studiesmentioning

confidence: 99%

Applications of SMILE-extracted lenticules in ophthalmology

Aghamollaei,

Fallahtafti,

Daryabari

et al. 2024

Int J Ophthalmol

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AIM: To review recent innovations, challenges, and applications of small incision lenticule extraction (SMILE) extracted lenticule for treating ocular disorders. METHODS: A literature review was performed in the PubMed database, which was last updated on 30 December 2021. There was no limit regarding language. The authors evaluated the reference lists of the collected papers to find any relevant research. RESULTS: Due to the simplicity and accuracy of modern femtosecond lasers and the extensive development of SMILE surgery, many healthy human corneal stromal lenticules were extracted during surgery, motivating some professionals to investigate the SMILE lenticule reusability in different ocular disorders. In addition, new approaches had been developed to preserve, modify, and bioengineer the corneal stroma, leading to the optimal use of discarded byproducts such as lenticules from SMILE surgery. The lenticules can be effectively re-implanted into the autologous or allogenic corneas of human subjects to treat refractive errors, corneal ectasia, and corneal perforation and serve as a patch graft for glaucoma drainage devices with better cosmetic outcomes. CONCLUSION: SMILE-extracted lenticules could be a viable alternative to human donor corneal tissue.

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Thirty-month results after the treatment of post-LASIK ectasia with allogenic lenticule addition and corneal cross-linking: a case report

Cited by 8 publications

References 20 publications

Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review

Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review

Long-Term Follow-Up of Accelerated Transepithelial Corneal Crosslinking for Post-LASIK Ectasia: A Pilot Prospective Observational Study

Applications of SMILE-extracted lenticules in ophthalmology

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