Ultrastructural and Immunohistochemical Characteristics of Corneal Lenticule Extracted during Correction of Residual Myopia in the Long-Term Period after SMILE

Purpose: To evaluate ultrastructural characteristics of lenticule surface extracted during correction residual myopia in patients after small-incision extraction (SMILE). Methods and material: This study had a prospective, consecutive, comparative design. Sixteen (16 eyes) underwent additional intervention for SMILE. 16 specimens removed lenticules morphological examination. Markers reagents were used to determine actin microfilaments, neutral fats cell nuclei. The tissue was analyzed layers 2D slices form, volumetric Z-stacks, or selected areas formed orthogonal projections. the using scanning electron microscopy. Patients’ refractive outcomes measured postoperatively (1 day; 1 3 months). Results: Postoperatively uncorrected distance visual acuity (20/20 better) 100% cases months surgery. Ultrastructural studies have shown difference surfaces newly lenticule. Structural changes posterior characterized by ruptures collagen fibers on its surface, degenerative keratocytes with signs colliquation necrosis, apoptosis F-actin cytoplasm. Conclusion: Collagen are immersed stroma anterior There is no complete structure restoration explaining lack tight adhesion intrastromal space even long-term postoperative period. that is, their SMILE reversible most cases.