Human stromal corneal lenticule implantation for refractory full-thickness macular holes: surgical technique and preliminary outcomes

Biological scaffolds have been explored in ophthalmology to improve structural and regenerative outcomes. Refractory full-thickness macular hole (rFTMH) remains a surgical challenge, as currently available techniques primarily aim at anatomical closure without consistently achieving functional recovery [ 1 ]. Human stromal corneal lenticules (hSCLs) represent a biocompatible stromal tissue that has previously been used in the treatment of keratoconus, showing promising potential in bioengineering approaches with regenerative factors [ 2 , 3 , 4 ]. Earlier studies have described the use of smile-derived hSCLs for the treatment of various vitreoretinal conditions; however, to date, their clinical application remains limited in Europe [ 5 , 6 ]. Recently, our group described the use of decellularized corneal lenticules in FTMH in an ex vivo porcine FTMH model, demonstrating successful human stromal corneal lenticules (hSCLs) implantation through both clinical and histological analyses [ 7 ].