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Post Info TOPIC: Stromal Keratophakia


Phase Two

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Posts: 484
Date: Thu Jun 3 7:40 PM, 2021
Stromal Keratophakia
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Here is a description of the procedure by kind courtesy of Dr Krolo,

Ophthalmologist and Anterior eye Segment Subspecialist.

 

 

'The name is stromal keratophakia, a method first described in 1960s by José Ignacio Barraquer. The thought behind it is that lenticules could be implanted into corneal stromal layers to restore volume and alter the refractive properties of the cornea in patients with corneal ectasias. By that time, sculpting of the donor stromal lenticule and lamellar keratectomy of the recipient's cornea were performed with a mechanical microkeratome, so the quality of the cut was inconsistent with many complications arising. Nowadays, it is re-emerging with the use of femtosecond lasers.'



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Veteran Member

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Posts: 93
Date: Thu Jun 3 7:42 PM, 2021
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Thanks very much for posting this, it looks very interesting! smile



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Veteran Member

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Posts: 26
Date: Thu Jun 3 7:48 PM, 2021
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 Something similar covered here https://www.frontiersin.org/articles/10.3389/fmed.2021.650724/full?fbclid=IwAR0e-6bSv9M0Lv4iFSIoLi2zD0-mX0p0iQEVO5-k8kC-e6HxE4vchKERRpI 

"Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment

  • 1Optica General, Saida, Lebanon
  • 2Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
  • 3Faculty of Sciences, GSBT Genomic Surveillance and Biotherapy Team, Mont Michel Campus, Lebanese University, Beirut, Lebanon
  • 4Doctoral School of Sciences and Technology, Lebanese University, Hadath, Lebanon
  • 5Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
  • 6Cell Engineering Laboratory, IdiPAZ, La Paz Hospital Research Institute, Madrid, Spain

The use of advanced therapies with stem cells to reconstruct the complex tissue of corneal stroma has gained interest in recent years. Besides, collagen-based scaffolds bioengineering has been offered as another alternative over the last decade. The outcomes of the first clinical experience with stem cells therapy on corneal stroma regeneration in patients with advanced keratoconus were recently reported. Patients were distributed into three experimental groups: Group 1 (G-1) patients underwent implantation of autologous adipose-derived adult stem cells (ADASCs) alone, Group 2 (G-2) received a 120 m decellularized donor corneal stromal laminas, and Group 3 (G-3) received a 120 m recellularized donor laminas with ADASCs. A follow up of 36 months of clinical data, and 12 months of confocal microscopy study was performed, the authors found significant clinical improvement in almost all studied mean values of primary and secondary outcomes. Corneal confocal microscopy demonstrated an increase in cell density in the host stroma, as well as in the implanted tissue. Using different approaches, allogenic small incision lenticule extraction (SMILE) implantation was applied in cases with advanced keratoconus. Some authors reported the implantation of SMILE intrastromal lenticules combined with accelerated collagen cross-linking. Others performed intrastromal implantation of negative meniscus-shaped corneal stroma lenticules. Others have compared the outcomes of penetrating keratoplasty (PKP) vs. small-incision Intralase femtosecond (IFS) intracorneal concave lenticule implantation (SFII). Femtosecond laser-assisted small incision sutureless intrasotromal lamellar keratoplasty (SILK) has been also investigated. The published evidence shows that the implantation of autologous ADASCs, decellularized or recellularized human corneal stroma, allogenic SMILE lenticules corneal inlay, and recombinant cross-linked collagen have shown initially to be potentially effective for the treatment of advanced keratoconus. In light of the present evidence available, it can be said that the era of corneal stromal regeneration therapy has been already started."



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