Photocrosslinked dual-network hydrogel for sutureless corneal stromal lenticule lmplantation

Corneal stromal lenticules obtained through small incision lenticule extraction (SMILE) procedures offer a valuable graft material for therapeutic applications. Current clinical utilization faces challenges due to intrinsic thinness (<140 μm) and restricted dimensions (generally around 6.6 mm). This study introduced a novel approach to enable the construction of customizable corneal grafts by stacking lenticules, achieving specific thickness and diameter for diverse corneal defects, using photo-crosslinked dual-network hydrogels based on methacrylated gelatin (GelMA). In vitro characterization confirmed the hydrogel's suitable morphological architecture, optical clarity, and excellent biocompatibility, establishing it as an optimal biological adhesive for sutureless graft implantation. This multi-lenticule encapsulation strategy using the hydrogels successfully reconstructed experimental rabbit corneal defects (7.0-mm diameter) in vivo. Over a 5-week postoperative period, the hydrogel demonstrated controlled biodegradation while maintaining structural integrity and optical functionality throughout tissue remodeling. It effectively adhered to the surrounding stromal tissues and supported epithelial regeneration over the transplanted grafts. The study demonstrates sutureless-free corneal stromal lenticule implantation, enabled by the GelMA-based photocrosslinked dual-network hydrogel, addressed the limitations of individual SMILE lenticules. The GelMA-based photocrosslinked dual-network hydrogel serves as both a biocompatible adhesive for multi-lenticule implantation and an optimal functional material for reconstructing corneal defects.