{
  "abstract": "Purpose Currently, stromal lenticules obtained from Small Incision Lenticule Extraction (SMILE) refractive surgery are often discarded as medical waste, despite their potential for reimplantation in therapeutic applications. These lenticules can be repurposed for procedures such as corneal thickness augmentation in patients with keratoconus, the creation of scleral patches, and other advanced ophthalmic treatments. However, proper preservation of these lenticules is essential to ensure safety and optimal clinical outcomes, and there is currently no consensus on the optimal preservation technique. Our objective is to establish a comprehensive protocol for the long-term preservation of these lenticules, ensuring that their safety and structural integrity are maintained both before and after storage. The two conservation methods we have evaluated are cryopreservation and dehydration. Both techniques are being examined to determine the most effective method of preserving the lenticules while maintaining their clinical usability.Methods We preserved stromal lenticules using two methods: cryoconservation at -80°C in DMSO (dimethyl sulfoxide) for 14 days, and dehydration followed by storage at 4°C with silica gel for 14 days. In addition, fresh lenticules were used as a control. After the preservation period, we evaluated the preserved lenticules and compared them to the fresh samples, as described below:Optical Coherence Tomography (OCT): Used to measure lenticule thickness and diameter, ensuring that these parameters remain consistent throughout preservation;A validated custom device (Parekh, Ferrari, et al., 2014): used to assess lenticule transparency, a critical factor for ensuring that reimplanted lenticules maintain optical clarity;Histological Analysis: Performed using Hematoxylin and Eosin (H&E), Periodic Acid-Schiff (PAS), and Masson’s Trichrome stains to evaluate the lenticule’s structural integrity and shape before and after preservation;Immunofluorescence Analysis: Conducted to assess the integrity of the collagen matrix, which is crucial for maintaining the biomechanical properties of the lenticule.Results The results obtained show that lenticule thickness has increased after transport and preservation. However, lenticule’s transparency, and biochemical integrity were maintained throughout both transport and preservation processes. Notably, immunofluorescence analysis using collagen I marker demonstrated that collagen integrity remained intact throughout both preservation method. In addition, histological analysis revealed the absence of significant degradation and an integrated biochemical structure comparable to fresh tissue, confirming the preservation of tissue architecture.Conclusion Our results demonstrated that preserved lenticules are comparable in structure and quality to fresh ones. Based on these promising findings, we are moving forward with obtaining authorization from the National Transplant Center to establish an official lenticule banking protocol. This biobank would provide a valuable and readily available resource for ophthalmic surgeons, offering stored stromal lenticules for a wide range of therapeutic applications, including keratoconus treatment and scleral reinforcement, thereby enhancing access to corneal tissue for reimplantation.",
  "authors": [
    {
      "affiliations": [
        "International Center for Ocular Physiopathology (ICOP), Veneto Eye Bank Foundation, Venice, Italy"
      ],
      "name": "Raimy Christodoulou Shoufani"
    },
    {
      "affiliations": [
        "Centro Oculistico Bresciano, Brescia, Italy"
      ],
      "name": "Alessandro Boldini"
    },
    {
      "affiliations": [
        "International Center for Ocular Physiopathology (ICOP), Veneto Eye Bank Foundation, Venice, Italy"
      ],
      "name": "Raluca Bievel Radulescu"
    },
    {
      "affiliations": [
        "International Center for Ocular Physiopathology (ICOP), Veneto Eye Bank Foundation, Venice, Italy"
      ],
      "name": "Diego Ponzin"
    },
    {
      "affiliations": [
        "International Center for Ocular Physiopathology (ICOP), Veneto Eye Bank Foundation, Venice, Italy"
      ],
      "name": "Stefano Ferrari"
    }
  ],
  "title": "6.1. Seeing beyond the SMILE: a biobank for SMILE-derived stromal lenticules for therapeutic use",
  "uid": "30cae8d0-f65e-5187-b616-812bcdc530cf"
}