Partial thickness cornea tissue from small incision lenticule extraction

Wang, Yuhong; Li, Xiaofeng; Huang, Weiyi; Liu, Jinkun; Xu, Yazhang; Chen, Meizhu; Wang, Qian

doi:10.1097/md.0000000000014500

Cited by 8 publications

(11 citation statements)

References 32 publications

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“…The most commonly used materials are preserved sclera, pericardium, dura mater, amniotic membrane, and donor cornea. 4 , 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 Many materials are expensive, difficult to obtain, or may not provide a cosmetically acceptable appearance. Amniotic membranes used in recent years reduce scleral melting and accelerate epithelialization but provide weak tectonic support in deep tissue loss.…”

Section: Discussionmentioning

confidence: 99%

Donor Cornea Use in Scleral Surface Reconstruction

Burcu¹,

Yalnız-Akkaya²,

Şingar³

et al. 2021

tjo

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Objectives: To investigate the indications for and results of treating scleral surface problems with donor corneal grafts that are not used in keratoplasty surgery or are left over from keratoplasty. Materials and Methods: The records of 16 patients in whom corneal tissue was used to repair a scleral tissue defect or cover an exposed glaucoma drainage implant were evaluated retrospectively. Partial-thickness grafts were prepared using a combined microkeratome system with artificial anterior chamber in 10 eyes and by manual dissection in 3 eyes. Full-thickness grafts were used in 3 eyes. Results: There were 8 female and 8 male patients aged 5-79 years (mean: 39.37±24.68). Indications for the use of corneal tissue on the scleral surface were limbal dermoid excision (n=2), pterygium surgery (n=1), intraocular lens removal and scleral fixation intraocular lens (SFIOL) implantation (n=1), exposed SFIOL suture coverage (n=1), trauma (n=2), scleral tissue loss due to repeated glaucoma surgeries (n=5), and exposed glaucoma drainage implant (n=4). The patients were followed for 6-42 months (mean: 14.37±9.14). None of the patients had graft infection, thinning, immunological graft rejection, or vision loss during follow-up. Tectonic lamellar grafts did not adversely affect final visual acuity in any case. At final examination, a good combination of graft and recipient tissue, a smooth ocular surface, and a cosmetic appearance were achieved in all eyes. Conclusion: Donor corneas that are not suitable for corneal transplantation or left over from the cornea transplant can be used in patients with scleral tissue loss due to various pathologies and in the treatment of glaucoma drainage implant erosion. In these cases, the use of corneal grafts provides a good ocular surface restoration and cosmetic appearance. The effectiveness and safety of this method should be investigated with large patient series and long follow-up times.

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Section: Discussionmentioning

confidence: 99%

Donor Cornea Use in Scleral Surface Reconstruction

Burcu¹,

Yalnız-Akkaya²,

Şingar³

et al. 2021

tjo

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“…[64,65] However, this additional processing might not be necessary because mid-to-long term follow-up have not reported any adverse immunological events with unmodified lenticules in recipients. [66][67][68][69] Certainly, immune cells have been detected in fresh lenticules compared to few or none in preserved specimens. [70] We confirmed this notion by identifying a population of CD45 + leukocytes within lenticules, further specifying them as CD14 + macrophages (Figure 5a, first-third columns).…”

Section: Immunogenicity Of Lenticules and Cultivation Of Trigeminal G...mentioning

confidence: 99%

A Bioengineering‐Regenerative Medicine Approach for Ocular Surface Reconstruction Using a Functionalized Native Cornea‐Derived Bio‐Scaffold

Park,

Richardson,

Delic

et al. 2023

Adv Funct Materials

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Limbal stem cell deficiency (LSCD) is characterized by the loss of limbal epithelial stem cells (LESCs) which compromises corneal transparency, leading to blindness. It cannot be treated with pharmacological or corneal transplantation interventions, instead a specialized stem cell (SC) therapy is needed to restore eye health and sight. Herein, a native cornea‐derived biomaterial, a by‐product of a laser refractive surgical procedure called small incision lenticule extraction is identified as a new cell delivery matrix. Culture conditions are optimized to facilitate LESC attachment, expansion and stratification, and their identity is immunophenotyped. Using electron microscopy, bio‐constructs display stratification, similar to the architectural and cellular organization of a native mammalian cornea with formation of a basement membrane and an orderly array of collagen fibrils. Neuronal growth and depleted CD45+/CD14+ leukocytes on lenticules are also shown, suggesting that in transplantation experiments, they will re‐innervate and not trigger a host‐mediated immune response. Finally, human lenticules are geometrically customized to successfully fit them over a LSCD murine cornea ex vivo, during which they maintain curvature. The authors are poised to conduced similar studies in live mice using these and other carriers currently used in the clinic to compare SC therapy outcomes.

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“…Since 2015, we have experimented and used 3 layers of lamellar corneal tissue acquired from SMILE surgery as patch grafts in drainage implant surgery. [ 14 ] The diameter of the lamellar corneal tissue is approximately 7 mm, and each layer is 100- to 150-μm thick. Our research provided that 3 layers of corneal graft could effectively prevent drainage tube exposure.…”

Section: Introductionmentioning

confidence: 99%

“…Since 2015, we have experimented and used 3 layers of lamellar corneal tissue acquired from SMILE surgery as patch grafts in drainage implant surgery. [14] The diameter of the Editor: Khaled Ahmed Abdelrahman.…”

Section: Introductionmentioning

confidence: 99%

The best thickness of cornea graft from SMILE surgery as patch graft in glaucoma drainage implant surgery

et al. 2021

Self Cite

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Objective: The aim of this study was to determine the best thickness of corneal slices acquired from femtosecond laser surgery—small incision lenticule extraction (SMILE surgery) as patch graft in glaucoma drainage implantation surgery. Methods: This study is a prospective randomized study. Patients who received glaucoma drainage implantation from September 2016 to November 2018 were observed. The patients were randomly divided into 3 groups. Group A included 102 cases (104 eyes), receiving 1 layer (120–150 μm) of allogeneic lamellar corneal tissue as the graft. Group B included 117 cases (120 eyes), receiving 2 layers of lamellar corneal tissue from one donor. Group C included 109 cases (111 eyes), using 3 layers of lamellar corneal tissue from 2 donors. The intraocular pressure, corneal graft, conjunctiva stromalysis, drainage tube exposure, and drainage plate were observed. Results: Patients were followed up for 6 to 33 months. The intraocular pressure was significantly reduced after surgery in all three groups. Conjunctiva stromalysis and drainage tubes were exposed in 3 eyes (3%) in group A and 1 eye (0.8%, a special case which has nystagmus and the plate was placed infratemporally) in group B, whereas no conjunctiva stromalysis or tube exposure was reported in group C. Conclusions: The corneal graft acquired from SMILE surgery can effectively prevent drainage tube exposure and give patients a better cosmetic appearance. Two layers of lamellar corneal tissue (240–300 μm) may be the best suitable thickness because it can effectively reduce tube exposure and rejection. In some special cases, 3 layers of lamellar corneal tissue are needed.

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Partial thickness cornea tissue from small incision lenticule extraction

Cited by 8 publications

References 32 publications

Donor Cornea Use in Scleral Surface Reconstruction

Donor Cornea Use in Scleral Surface Reconstruction

A Bioengineering‐Regenerative Medicine Approach for Ocular Surface Reconstruction Using a Functionalized Native Cornea‐Derived Bio‐Scaffold

The best thickness of cornea graft from SMILE surgery as patch graft in glaucoma drainage implant surgery

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