title: Using Donor Lenticules Obtained Through SMILE for an Epikeratophakia Technique Combined With Phototherapeutic Keratectomy.
abstract: OBJECTIVE
  To investigate the feasibility, safety, and efficacy of using a donor lenticule created during small incision lenticule extraction (SMILE) in an epikeratophakia technique combined with phototherapeutic keratectomy (PTK).
  
  
  METHODS
  Six patients with decreased visual acuity due to a recurrence of corneal dystrophy were included in this prospective pilot study. PTK was performed using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany) followed by the transplantation of donor lenticules onto the recipient eyes. These lenticules were extracted during SMILE procedures using the VisuMax femtosecond laser (Carl Zeiss Meditec) on 6 donors with myopia and served as the epikeratophakia tissue.
  
  
  RESULTS
  The surgeries and postoperative follow-up examinations were uneventful and no complications were noted over 6 months of follow-up. The epithelium remodelling was achieved within 1 month. At the last measurement, the corrected distance visual acuity of all recipient eyes gained at least two lines. Five eyes (83.3%) gained at least two lines of uncorrected distance visual acuity compared to their preoperative levels. Mean keratometric power increased by 5.97 ± 3.73 diopters and central corneal thickness increased by 55.25 ± 36.38 µm. The epithelium healed and the lenticules remained clear over the follow-up period as observed under slit-lamp examination. Anterior segment optical coherence tomography observation showed the lenticule was transparent with a visible demarcation line during the follow-up examination.
  
  
  CONCLUSIONS
  The use of a SMILE lenticule as a donor lenticule for an epikeratophakia technique appears feasible and safe in the short term. The predictability and long-term effects need further investigation. [J Refract Surg. 2016;32(12):840-845.].
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.forename: Yang
authors.initials: Y
authors.lastname: Shen
authors.forename: Mi
authors.initials: M
authors.lastname: Tian
authors.forename: Peijun
authors.initials: P
authors.lastname: Yao
authors.forename: Xingtao
authors.initials: X
authors.lastname: Zhou
mesh_terms: D000328:Adult; D002648:Child; D003317:Corneal Dystrophies, Hereditary / Q000503:physiopathology / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery / Q000637:transplantation*; D017391:Epikeratophakia / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology