Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review

Ophthalmol Ther. 2023 Oct;12(5):2361-2379. doi: 10.1007/s40123-023-00765-2. Epub 2023 Jul 29.

Abstract

Introduction: Intrastromal lenticule implantation is a promising treatment option for corneal pathologies, from refractive error to ectasia. In this narrative review, we intend to feature up-to-date literature supporting the use of lenticular tissue, a compelling method that can be customized for a variety of applications, providing an additional source of donor tissue for treating corneal diseases.

Methods: We searched databases PubMed, Mendeley, and Scopus last accessed 10 May 2023, for literature on stromal lenticules and narrowed based on relevance. Review articles, animal studies, ex vivo studies, and book chapters were excluded, while assessable and relevant articles published in English were included.

Results: Storage methods from using fresh lenticules to dehydration have proven successful, with cryopreservation maintaining structure and cellular viability for up to 10 years. Successful use of lenticules for treatment of numerous pathologies including corneal ectasias, hyperopia, and presbyopia with additional insight into the treatment of corneal ulcers and perforations are highlighted in this narrative review.

Conclusion: Lenticular implantation is an innovative and advantageous treatment for various ocular pathologies, offering increased bioavailability, flexibility, and customization for patients. They can treat previously untreatable diseases and serve as a replacement for synthetic implants, with promising outcomes worldwide. Lenticular implantation has the potential to become a leading approach in ophthalmologic surgery. Further studies should aim to provide evidentiary support for a standardization of lenticule banking.

Keywords: ALK; Allogenic lenticule implantation; CAIRS; Corneal storage medium; Hyperopia; Intrastromal keratoplasty; Necklace lenticule; PEARL; Presbyopia; SMILE.

Publication types

  • Review