# The Preservation and Reuse of Lenticules Extracted via Small Incision Lenticule Extraction (SMILE): A Narrative Review

## TL;DR

This paper reviews how lenticules from SMILE eye surgery can be preserved and reused to treat corneal diseases and address donor tissue shortages.

## Contribution

The paper provides a comprehensive review of current and potential methods for preserving and reusing SMILE-extracted lenticules.

## Key findings

- SMILE lenticules have properties suitable for treating corneal diseases and reducing donor cornea shortages.
- No universally accepted preservation method exists due to challenges in tissue integrity and long-term storage.
- Reusing lenticules offers new possibilities for treating conditions like hyperopia and keratoconus.

## Abstract

Small-incision lenticule extraction (SMILE) is a safe and effective procedure to correct myopia and myopic astigmatism. The corneal stromal lenticules extracted from SMILE surgery have good light transmission, mechanical properties, and biocompatibility, which are suitable for the treatment of a variety of corneal diseases and can solve the problem of donor cornea shortage. At present, no single method of preserving corneal stromal lenticules has been universally accepted as ideal, as the preservation of tissue integrity, optical transmittance, cellular viability, and the potential for long-term storage remain key challenges. Current approaches include short-term preservation methods such as the use of dehydrating agents and Optisol GS, and long-term preservation strategies such as cryopreservation, hydrogel nutrient capsules, and silicone oil. Standardized storage methods can improve the use of SMILE-derived lenticules as a substitute for donor corneal tissue in clinical settings. The reuse of corneal stromal lenticules is a highly regarded research area, especially in hyperopia, presbyopia, keratoconus, and some corneal ulcerative diseases, providing new possibilities for addressing corneal tissue shortage and improving surgical outcomes. Here, we review various preservation methods and clinical applications of SMILE-extracted lenticules, highlighting their potential in addressing corneal tissue shortages and the treatment of a variety of corneal diseases.