SMILE-derived transplant procedure opens new frontier in treatment of corneal diseases
Click Here to Manage Email Alerts
Stromal lenticule addition keratoplasty, a technique that uses the lenticules derived from ReLEx SMILE surgery, offers a valid alternative for the treatment of keratoconus, according to a speaker at the virtual EuCornea congress.
“SLAK relies on implanting a negative meniscus-shaped lenticule that is thinner in the center and thicker in the periphery to reshape and stabilize the cornea in eyes with progressive keratoconus,” Mario Nubile, MD, said.
The lenticule, produced with femtosecond laser on donor corneas, is implanted in a corneal pocket created by the same femtolaser system in the recipient eye at a depth of about 150 µm in the anterior stroma. Clinical studies on human eyes with keratoconus were performed.
“Topographic analysis showed that the addition of the lenticule within the stroma produced an overall flattening of the central region of the cornea, along with central and paracentral thickening. This resulted in improved BCVA and UCVA, as well as significant reduction in mean spherical equivalent and refractive astigmatism,” Nubile said.
A study extension that includes more cases and a follow-up to 24 months has shown stable results in terms of keratometry changes and corneal anterior asphericity. The lenticule remains clear, and signs of opacification or haze are rare, as is rejection, because the antigen load of stromal implantation is low.
One additional benefit of this technique is that the increase in corneal stromal thickness allows the performance of corneal cross-linking.
Restoring the corneal thickness profile helps to better tolerate the cross-linking procedure and stabilize the cone, Nubile said.
Future studies will include the use of decellularized, bioengineered lenticules, with several clinical applications.
Collapse
Nubile M. Femtosecond laser assisted stromal lenticule addition keratoplasty (SLAK). Indications and technique. Presented at: EuCornea congress; Sept. 26, 2020 (virtual meeting).
Read more about
Click Here to Manage Email Alerts