Reversible femtosecond laser-assisted endokeratophakia using cryopreserved allogeneic corneal lenticule

Yuan Sun, Ting Zhang, Yuehua Zhou, Manli Liu, Yugui Zhou, Xiaonan Yang, Shengbei Weng, Chi Ho To, Quan Liu

Research output: Journal article publicationJournal articleAcademic researchpeer-review

8 Citations (Scopus)


PURPOSE: To evaluate outcomes, reversibility, and wound healing response after the femtosecond laserassisted endokeratophakia procedure in a rabbit model. METHODS: Allogeneic rabbit corneal lenticules were cryopreserved in liquid nitrogen for 3 months. Twenty rabbits underwent the monocular endokeratophakia procedure and were divided into four groups according to the follow-up periods. The first three groups were killed at 3 days, 2 weeks, and 6 months after endokeratophakia, respectively. The rabbits in the fourth group received re-extraction of implanted lenticules at 6 months after endokeratophakia and were killed at 1 month after re-extraction. The rabbits were monitored by slit-lamp microscopy, ultrasonic pachymetry, in vivo confocal microscopy, optical coherence tomography (OCT), Corvis ST tonometry (Oculus Optikgeräte, Wetzlar, Germany), and Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, NY). The tissue responses were analyzed by immunohistochemistry and transmission electron microscopy. RESULTS: After endokeratophakia, corneal clarity improved continually with time. The changes in the refraction and corneal thickness were stable after implantation and could be reversed after re-extracting the lenticules. The interfaces were clearly visible on confocal microscopy and transmission electron microscopy images over the entire follow-up period. There were significant numbers of TUNEL-positive keratocytes in lenticules after endokeratophakia. CD11b-positive cells and deposition of fibronectin and tenascin were observed at earlier follow-up times. No alpha-smooth muscle actinpositive fibroblasts could be detected. In addition, the corneal biomechanics parameters were not significantly increased after endokeratophakia. CONCLUSIONS: The endokeratophakia procedure using allogeneic cryopreserved lenticules was clinically stable and could be reversed. The wound healing response was mild, limited, and produced no scars.
Original languageEnglish
Pages (from-to)569-576
Number of pages8
JournalJournal of Refractive Surgery
Issue number8
Publication statusPublished - 1 Aug 2016

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

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