: Human stromal corneal lenticules (hSCLs) extracted during keratorefractive lenticule extraction (KLEx) refractive surgery, including Small incision lenticule extraction (SMILE) procedure, are often discarded as medical waste, despite their potential for reimplantation in various ocular therapeutic applications. These include corneal thickness restoration in keratoconus, scleral patch grafts, and other ophthalmic procedures. Ensuring the safety and structural integrity of these lenticules for clinical use depends on proper preservation; however, a consensus on the most effective preservation method has yet to be reached. Hence, this study aimed to establish a comprehensive preservation protocol of SMILE-hSCLs, evaluating both pre-storage transportation media and long-term storage methods. In particular, we tested two pre-storage transport media, hyaluronic acid (HA) and Coldix, a dextran-containing MEM medium commonly used in our eye bank for corneal hypothermic storage, and three long-term (two weeks) preservation techniques represented by silica gel dehydration, cryopreservation in DMSO and glycerol. Our results demonstrated that hSCLs transported in either HA or Coldix for 48 h retained transparency, size, morphology, thickness and biological properties comparable to fresh tissues. However, hSCLs transported in HA exhibited superior overall collagen structural integrity. While, among the three tested long-term storage methods, both dehydration and cryopreservation in glycerol ensured effective preservation of corneal tissue. In summary, our findings identified HA as an effective pre-storage transport medium and demonstrated that both silica gel dehydration and glycerol-based cryopreservation are suitable strategies for the long-term preservation of SMILE-derived hSCLs. Although cryopreservation ensures good tissue preservation, the need for specialized equipment may pose a barrier to implementation in certain settings. In contrast, dehydration might offer a practical, low-cost solution ideal for establishing off-the-shelf hSCL biobanks, particularly in resource-limited settings. Collectively, these results lay the groundwork for a standardized and scalable preservation protocol to support future clinical use of KLEx-derived lenticules.
Human stromal corneal lenticules (hSCLs) extracted during keratorefractive lenticule extraction (KLEx) refractive surgery, including Small incision lenticule extraction (SMILE) procedure, are often discarded as medical waste, despite their potential for reimplantation in various ocular therapeutic applications. These include corneal thickness restoration in keratoconus, scleral patch grafts, and other ophthalmic procedures. Ensuring the safety and structural integrity of these lenticules for clinical use depends on proper preservation; however, a consensus on the most effective preservation method has yet to be reached. Hence, this study aimed to establish a comprehensive preservation protocol of SMILE-hSCLs, evaluating both pre-storage transportation media and long-term storage methods. In particular, we tested two pre-storage transport media, hyaluronic acid (HA) and Coldix, a dextran-containing MEM medium commonly used in our eye bank for corneal hypothermic storage, and three long-term (two weeks) preservation techniques represented by silica gel dehydration, cryopreservation in DMSO and glycerol. Our results demonstrated that hSCLs transported in either HA or Coldix for 48 h retained transparency, size, morphology, thickness and biological properties comparable to fresh tissues. However, hSCLs transported in HA exhibited superior overall collagen structural integrity. While, among the three tested long-term storage methods, both dehydration and cryopreservation in glycerol ensured effective preservation of corneal tissue. In summary, our findings identified HA as an effective pre-storage transport medium and demonstrated that both silica gel dehydration and glycerol-based cryopreservation are suitable strategies for the long-term preservation of SMILE-derived hSCLs. Although cryopreservation ensures good tissue preservation, the need for specialized equipment may pose a barrier to implementation in certain settings. In contrast, dehydration might offer a practical, low-cost solution ideal for establishing off-the-shelf hSCL biobanks, particularly in resource-limited settings. Collectively, these results lay the groundwork for a standardized and scalable preservation protocol to support future clinical use of KLEx-derived lenticules.
Biological assessment and preservation strategies for SMILE- derived lenticules: towards a corneal regenerative biobank
Ferrari S.;Ponzin D.;
2026
Abstract
Human stromal corneal lenticules (hSCLs) extracted during keratorefractive lenticule extraction (KLEx) refractive surgery, including Small incision lenticule extraction (SMILE) procedure, are often discarded as medical waste, despite their potential for reimplantation in various ocular therapeutic applications. These include corneal thickness restoration in keratoconus, scleral patch grafts, and other ophthalmic procedures. Ensuring the safety and structural integrity of these lenticules for clinical use depends on proper preservation; however, a consensus on the most effective preservation method has yet to be reached. Hence, this study aimed to establish a comprehensive preservation protocol of SMILE-hSCLs, evaluating both pre-storage transportation media and long-term storage methods. In particular, we tested two pre-storage transport media, hyaluronic acid (HA) and Coldix, a dextran-containing MEM medium commonly used in our eye bank for corneal hypothermic storage, and three long-term (two weeks) preservation techniques represented by silica gel dehydration, cryopreservation in DMSO and glycerol. Our results demonstrated that hSCLs transported in either HA or Coldix for 48 h retained transparency, size, morphology, thickness and biological properties comparable to fresh tissues. However, hSCLs transported in HA exhibited superior overall collagen structural integrity. While, among the three tested long-term storage methods, both dehydration and cryopreservation in glycerol ensured effective preservation of corneal tissue. In summary, our findings identified HA as an effective pre-storage transport medium and demonstrated that both silica gel dehydration and glycerol-based cryopreservation are suitable strategies for the long-term preservation of SMILE-derived hSCLs. Although cryopreservation ensures good tissue preservation, the need for specialized equipment may pose a barrier to implementation in certain settings. In contrast, dehydration might offer a practical, low-cost solution ideal for establishing off-the-shelf hSCL biobanks, particularly in resource-limited settings. Collectively, these results lay the groundwork for a standardized and scalable preservation protocol to support future clinical use of KLEx-derived lenticules.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
