Autologous Stromal Transplantation with Stromal Rejuvenation for Corneal Dermoids

Background: Corneal transplantation remains the mainstay of managing corneal dermoids. However, the shortage of donor corneas and complications related to allograft transplantation are the formidable challenges. We investigated whether autologous superficial corneal stromal transplantation could repair the deep defects caused by dermoids through stromal rejuvenation, thereby treating dermoids.<br><br>Methods: An uncontrolled, single-group study involved 19 patients with dermoids. After the removal of dermoids, a 120μm-thick stromal graft harvested from the same eye using femtosecond laser was transplanted. The primary outcomes were the corneal thickness and the corneal opacity in the transplanted area. The secondary outcomes were spherical equivalent, best corrected visual acuity, and astigmatism after surgery.<br><br>Findings: At 12 to 18 months after surgery, the corneal thickness in the transplanted area (530·89±56·84μm) was significantly greater than that (470·33±45·07μm) one week postoperatively (difference, 63·56; 95%CI, 45·29 to 81·82; P &lt; 0·001), the corneal thickness above 500μm was achieved in 14 of 19 treated eyes (73·7%; 95% CI, 51·9 to 95·5), and while no significant difference in the harvesting area at different follow-ups (P &gt; 0·05). The corneal opacity graded as 0 (completely clear) or 1 (minimal haze seen with difficulty) was recorded in 18 of 19 eyes (94·7%; 95%CI, 83·7 to 100) in the transplanted area.<br><br>Interpretation: Autologous superficial corneal stromal transplantation was followed by the increase of corneal thickness when managing dermoids, indicating that deep stromal defects could been repaired through endogenous stromal rejuvenation.