ArticleInvestigative ophthalmology & visual science2024
Ex Vivo Lenticule Customization for Stromal Lenticule Addition Keratoplasty.
Article in Investigative ophthalmology & visual science, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Preservation and Reuse of KLEx Lenticules: From Biobanking to Therapeutic and Refractive Innovations.Bioengineering (Basel, Switzerland) · 2026Review
- A novel method for evaluating the thickness and keratometry profiles of toric lenticules created by a new-generation keratorefractive lenticule extraction platform.Eye (London, England) · 2026Article
- Ex Vivo Assessment of Excimer Laser-Assisted Lenticule Customization.Translational vision science & technology · 2026Article
- Combined femtosecond intrastromal lenticular implantation and corneal crosslinking to treat advanced keratoconus: a 6-month observation including epithelial remodeling.BMC ophthalmology · 2025Article
- Evaluation of corneal asymmetry and higher-order aberrations after small incision lenticule extraction for moderate and high myopia.International ophthalmology · 2025Article
- Ultrastructural changes of corneal stromal lenticule after laser shaping.Experimental and therapeutic medicine · 2025Article
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Authors and funding
8 authors.
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Abstract
Purpose: The purpose of this study was to explore the optimal shape of customized lenticules for stromal lenticule addition keratoplasty (SLAK) for off-centered ectasia. Methods: Two different methods to create ex vivo models of eccentric-keratoconus were investigated. Twelve human corneas were used to create model 1 by a hyperopic photorefractive keratectomy (PRK), and model 2 by masked phototherapeutic keratectomy (PTK) on the anterior corneal surface, whereas both types received myopic ablation of the posterior surface. Keratoconus models underwent a modified femtosecond laser (FSL) flap-cut to create stromal pockets. Sixteen human corneas underwent FSL dissection to obtain four lenticule types: type I (planar) and type II (negative) lenticules were used without modifications, whereas type III (customized-planar), and type IV (customized-negative) lenticules underwent further masked-PRK to obtain an asymmetric bow-tie shape. Topographic, aberrometric analysis, and anterior segment optical coherence tomography (AS-OCT) were performed in all recipient corneas before and after lenticule implantation. Results: Keratoconus model was successfully reproduced. Tomographic analysis showed a significant inferiorly decentered corneal steepening with coherent stromal thinning. Model 2 reproduced better the curvature of real keratoconus. Lenticules type I implantation induced a homogeneous corneal thickening, type III produced higher thickening in the inferior half of the cornea. Type II determined a maximal peripheral pachymetric increase, with a gradual reduction toward the center, and type IV presented an asymmetric peripheral thickening. Topographic assessment showed a cone apex flattening in all cases, but it was significantly higher in types II and IV. Customized lenticules improved significantly corneal surface regularity regarding types I and II. Conclusions: The approach of customizing lenticules by increasing their asymmetry and tailoring the re-shaping effects, may improve SLAK outcomes in eccentric keratoconus.
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