2022
DOI: 10.3390/ijms23147967
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Human SMILE-Derived Stromal Lenticule Scaffold for Regenerative Therapy: Review and Perspectives

Abstract: A transparent cornea is paramount for vision. Corneal opacity is one of the leading causes of blindness. Although conventional corneal transplantation has been successful in recovering patients’ vision, the outcomes are challenged by a global lack of donor tissue availability. Bioengineered corneal tissues are gaining momentum as a new source for corneal wound healing and scar management. Extracellular matrix (ECM)-scaffold-based engineering offers a new perspective on corneal regenerative medicine. Ultrathin … Show more

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Cited by 20 publications
(28 citation statements)
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“…The technique does not rely on availability of donor corneas and tissue banking infrastructure and no advanced preservation methods are required as BPCDX can be stored in room temperature or in a refrigerator up to two years after manufacturing. Compared to earlier clinical trials with intrastromal implantation of thin lenticules or Bowman's layer transplantion 32,[94][95][96][97][98][99][100][101] , the BPCDX implants are much thicker resulting in significant corneal thickening and flattening and better visual outcomes. Importantly, the visual outcomes are similar to traditional transplantation surgeries with human donors for treating keratoconus 102 .…”
Section: Discussionmentioning
confidence: 92%
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“…The technique does not rely on availability of donor corneas and tissue banking infrastructure and no advanced preservation methods are required as BPCDX can be stored in room temperature or in a refrigerator up to two years after manufacturing. Compared to earlier clinical trials with intrastromal implantation of thin lenticules or Bowman's layer transplantion 32,[94][95][96][97][98][99][100][101] , the BPCDX implants are much thicker resulting in significant corneal thickening and flattening and better visual outcomes. Importantly, the visual outcomes are similar to traditional transplantation surgeries with human donors for treating keratoconus 102 .…”
Section: Discussionmentioning
confidence: 92%
“…Even if the femtosecond laser is ideal due to its accuracy, the intrastromal pocket can be created manually with microkeratome 32,94 when a femtosecond laser is not available. The corneal stroma of keratoconus patients has been previously enhanced by intrastromal implantation of allogenic SMILE-derived lenticules in a pocket created by femtosecond laser [95][96][97][98] . SMILE-lenticules have lower risk for rejection compared to donors used for penetrating and lamellar keratoplasty due to their size with fewer keratocytes and no epithelial or endothelial cells as well as their intrastromal implantation without encountering the anterior chamber or corneal surface 95 .…”
Section: Discussionmentioning
confidence: 99%
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“…Lenticule keratophakia and epikeratophakia are reversible in SMILE, and the visual quality offers unique advantages ( 56 , 57 ). Moreover, the discarded tissue was also reused as a bio-scaffold for stromal engineering, and an ocular drug delivery system of active molecules ( 58 , 59 ).…”
Section: Discussionmentioning
confidence: 99%