CORNEAL REGENERATION WITH FRESH LENTICULE TRANSPLANTATION FOR KERATOCONUS WITH 5-YEAR FOLLOW-UP RESULTS
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO010 | Type: Free Paper | DOI: 10.82333/z8r2-c154
Authors: Ceren Ece Semiz* 1 , Faruk Semiz 2 , Njomza Hima Musa 2 , Fetih Furkan Arslan 3 , Gamze Tanriverdi 4 , Merjem Purelku 4
1Refractive Surgery,Eye Hospital,Prishtina,Kosovo;Refractive Surgery,Eye Hospital,Prishtina,Kosovo;Refractive Surgery,Eye Hospital,Prishtina,Kosovo, 2Refractive Surgery,Eye Hospital,Prishtina,Kosovo, 3Ophthalmology,Istanbul-Cerrahpasa University,Istanbul,Türkiye, 4Embyrology and Histology,Istanbul-Cerrahpasa University,Istanbul,Türkiye
Purpose
To identify, quantify and understand the presence and role of active progenitor cells and telocytes (TC) in the human cornea using immunohistochemistry.
Setting
Eye Hospital, Prishtina, Kosovo
Methods
In this study, 60 eyes with advanced keratoconus requiring corneal transplantation underwent fresh myopic lenticule (FML) transplantation. The lenticules were sourced from routine SMILE procedures performed on myopic patients. Six lenticule samples were analyzed using immunohistochemistry with CD34 antibodies : one from an untreated keratoconic eye and five from treated keratoconic eyes at 1, 2, 3, 4, and 5 years post-surgery. -0.75 D (a 6.6 mm diameter lenticule with a minimum thickness of 20 µm) was extracted using SMILE from a patient with untreated keratoconus who had a preoperative central corneal thickness (CCT) of 419 µm. From five patients with keratoconus, treated at 1, 2, 3, 4, and 5 years after the initial surgery, a 6.60 mm diameter lenticule with a thickness of 120 µm and a refractive power of -6 D was removed as a whole. These lenticules underwent meticulous tissue processing for light microscopy and subsequent immunohistochemical staining.
Results
In the untreated keratoconic lenticules, CD34 staining showed irregular and thinned collagen fibers in the stroma, along with reduced cell numbers and degenerative morphological features. After lenticule transplantation, there was an initial increase in stromal cells, including CD34-positive progenitor cells and telocytes, observed in the lenticules from the first year post-treatment. This increase continued in the lenticules from the second and third years. However, by the fourth and fifth years, CD34 staining indicated a decline in cell numbers.
Conclusion
This analysis reveals dynamic changes in CD34-positive cell density during corneal tissue maturation post-operatively, with progenitor cells essential for repair and regeneration. The significant reduction of telocytes in keratoconus samples underscores their critical role in corneal pathology. These findings deepen our understanding of corneal biology and provide insights for enhancing therapeutic interventions in corneal repair and regeneration.