Outcome of a criminal eye injury after SMILE (small incision lenticule extraction)

Session Details

Session Title: Smile: Small Intrastromal Lenticule Extraction II

Session Date/Time: Tuesday 13/09/2016 | 16:00-17:30

Paper Time: 16:54

Venue: Hall C3

First Author: : O.Kostin RUSSIA

Co Author(s): :    S. Rebrikov   A. Ovchinnikov   A. Stepanov              

Abstract Details

Purpose:

SMILE operation provides preservation of the corneal biomechanical stability unlike both FLEx and FemtoLASIK. Our purpose is to present a clinical case and outcome of a blunt trauma after SMILE which illustrates this.

Setting:

IRTC Eye Microsurgery Ekaterinburg Center, Ekaterinburg, Russia

Methods:

Case report. SMILE for correction of slight myopia was performed in both eyes of a 35-year-old male and was uneventful. Before surgery uncorrected visual acuity was 20/250 in both eyes. Corrected distance visual acuity in the right eye was 20/20 (refractive error: - 2.00 sphere, - 0.75 cylinder ax 90). Corrected distance visual acuity in the left eye was also 20/20 (refractive error: - 2.25 sphere). Uncorrected visual acuity after surgery was 20/20 in both eyes.

Results:

6 weeks after SMILE operation the patient addressed to our center complaining for decreased visual acuity in the right eye after a blow from a fist in the right eye in a fight. A subconjunctival hemorrhage in the upper sector of the right eye was found. Zone of SMILE operation was unremarkable. In the macular region of the right eye a yellowish prominent focus 2 optic discs in diameter surrounded by subretinal hemorrhages was found Uncorrected visual acuity in the right eye was 20/80 and could not be improved with glasses. Subsequently visual acuity has restored up to 20/20.

Conclusions:

Traumatic dislocation of the corneal flap is one of rare but prognostically unfavorable complications of LASIK. It results in a decrease of visual acuity and requires repeated surgical intervention. Use of femtosecond lasers for corneal flap creation also does not solve the problem of traumatic flap dislocation after FemtoLASIK operation. SMILE operation, including removal of a corneal lenticule for refractive purpose through a microinvasive approach reduces the risk of corneal cap traumatic dislocation and gives hope for absence of traumatic changes that may occur in the postoperative period after LASIK and FemtoLASIK operations. The presented case supports this statement.

Financial Disclosure:

NONE