Optical transmittance and ultrastructure of SMILE-derived lenticules subjected to three different preservative methods

Abstract

PurposeTo investigate the optical transmittance and ultrastructure of small incision lenticule extraction (SMILE)-derived lenticules preserved via three different methods. MethodsA total of 90 lenticules obtained from myopic patients undergoing SMILE surgery were divided into control and experimental groups. Fresh lenticules served as the control. The preserved lenticules of the experimental group were randomly divided into three subgroups according to different storage conditions: anhydrous glycerol, silicone oil and allochroic silica gel groups. Optical transmittance was evaluated, histological changes were analysed by haematoxylin eosin (HE) staining, and collagen fibril densities and necrotic response were assessed via transmission electron microscopy (TEM) at 48 h, 14 days and 4 weeks. ResultsAfter storage for 4 weeks, the mean percentage transmittance values in glycerol and silicone oil groups significantly decreased (P = 0.034 and P = 0.042, respectively), but the lenticules preserved in silica gel remained unchanged when compared with the control lenticules. In all the groups, HE staining results showed a regular arrangement of collagen fibers with a few keratocytes and several cavitation bubbles. TEM revealed that the fibril densities in the glycerol group (273.70 ± 31.42/μm2) after 4 weeks were significant less than those in the other two groups (silicone oil, 335.20 ± 33.09/μm2; silica gel, 371.80 ± 37.60/μm2) and control group (340 ± 33.61/μm2) (all P < 0.001). In each group, a few necrotic and apoptotic keratocytes were observed. ConclusionsAll the three agents, namely glycerol, silicone oil and silica gel, could be used for lenticule preservation. Silica gel facilitates better maintenance of optical transmittance than the other two agents.