The aim of the present study was to investigate the feasibility and effects of Simultaneous replacement of stromal donor lenticul in cornea with ectasia during Smile surgery

Six patients with decreased visual acuity due to corneal ectasia were included in this prospective pilot study. These lenticules were extracted during SMILE procedures using the VisuMax femtosecond laser (Carl Zeiss Meditec) on 6 donors with myopia and Simultaneous replacement of stromal donor lenticul in cornea with ectasia. Pre- and postoperative (1 or 3 days, 1month, and 6 months) slit lamp microscopy, corneal topography, anterior segment optical coherence tomography, and in vivo confocal microscopy were performed.

The surgeries and postoperative follow-up examinations were uneventful and no complications were noted over 6 months of follow-up. At the last measurement, the corrected distance visual acu¬ity of all recipient eyes gained at least two lines. 2 eyes (33.3%) 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. Anterior segment optical coherence tomography observation showed the lenticule was transparent with a visible demarcation line during the follow-up examination.

This technique seems to be feasible and safe for increasing corneal stromal thickness and changing corneal refractive power, which may provide a useful method for treatment of keratoectasia, presbyopia, and hyperopia.