A pilot study on SMILE-derived lenticule patch implantation: stromal augmentation for various corneal pathologies.

OBJECTIVE

To evaluate the initial clinical outcomes of a small-incision lenticule extraction (SMILE)-derived lenticule patch graft for the management of corneal defects.

METHODS

Patients who underwent SMILE-derived lenticule patch graft implantation with sutures between 2016 and 2020 at 2 different tertiary-care referral hospitals were evaluated retrospectively. The etiology, logarithm of the minimum angle of resolution (logMAR)-equivalent best corrected visual acuity (BCVA), and globe integrity were evaluated. Additional surgical interventions and secondary surgeries were recorded. The follow-up duration was 1 year.

RESULTS

Sixteen eyes of 16 patients (9 females and 7 males) were included in the study. The mean age of the patients was 48.9 ± 19.6 (range: 24-80) years. The most common underlying etiologies were neurotrophic keratitis (18.7%), penetrating injuries (18.7%), and corneal melting due to inflammatory or rheumatological disorders (18.7%). The etiology was unknown in 4 patients (25.0%). Anatomic success in terms of corneal integrity was achieved in all 16 eyes after the procedure. The mean logMAR BCVA was 1.9 ± 0.8 before the surgery and 1.2 ± 0.7 after the surgery. In 3 patients, amniotic membrane transplantation was performed together with a lenticule patch. After the procedure, penetrating keratoplasty was performed in 4 patients (25.0%) to improve their BCVA.

CONCLUSIONS

Lenticule patch application to treat corneal defects secondary to various corneal pathologies is effective and reliable for preserving eye integrity. This method is particularly advantageous for patients unable to undergo a cornea transplant under emergency conditions until cornea donor tissue becomes available.