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.