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Ex Vivo Assessment of Excimer Laser-Assisted Lenticule Customization
Mohammed M Abusayf1,2,3,4,5, Evelina Han3, Yu-Chi Liu3,4,5
1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Translational Vision Science & Technology
|May 13, 2026
Summary
This study presents a new ex vivo method to assess excimer laser reshaping of corneal lenticules, crucial for developing stromal keratophakia techniques. The method demonstrated good reproducibility for evaluating laser modifications on lenticule thickness and curvature.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Corneal Surgery
Background:
- Corneal lenticule extraction techniques like SMILE and CLEAR are common for refractive correction.
- Assessing laser modifications on extracted lenticules ex vivo is essential for developing advanced applications like stromal keratophakia.
- Current methods often require lenticule implantation, limiting early-stage customization studies.
Purpose of the Study:
- To introduce and evaluate the reproducibility of a novel ex vivo method for assessing excimer laser-modified corneal lenticules.
- To analyze the morphological changes in lenticule thickness and curvature after laser ablation.
- To support the development of stromal keratophakia procedures, especially for conditions like keratoconus.
Main Methods:
- Developed an ex vivo method using a calibration sphere and anterior segment imaging to assess corneal lenticules.
- Subjected myopic (SMILE) and hyperopic (SMILE, CLEAR) lenticules to partial phototherapeutic keratectomy (PTK) with a masking technique.
- Measured lenticule thickness and curvature pre- and post-ablation using OCT and topography, applying a controlled dehydration protocol.
Main Results:
- Achieved good reproducibility in keratometry measurements (mean CV = 1.78%, CR = 0.57 for refined data).
- Excimer ablation significantly reduced ablated lenticule thickness (50.63 µm vs. 82.88 µm) and induced localized flattening (9.88 D).
- Demonstrated asymmetric regional curvature changes post-PTK, with greater flattening in hyperopic lenticules (12.50 D) than myopic (7.25 D).
Conclusions:
- The introduced ex vivo method allows for direct assessment of excimer laser reshaping on stromal lenticules without implantation.
- This technique facilitates the evaluation of customized reshaping strategies for stromal keratophakia applications.
- Further studies with larger sample sizes are warranted to refine the method and validate its clinical potential.
