Posters

Waking up from a nightmare with a SMILE: management and outcomes of retained lenticules and lenticule fragments removal after a complicated SMILE

Poster Details

First Author: A.Lazaridis GERMANY

Co Author(s): S. Brar   S. Ganesh                 

Abstract Details

Purpose:

To describe the management and report the outcomes following the removal of a retained lenticule fragment (case 1) and the removal of retained lenticules (cases 2 and 3) after a complicated Small Incision Lenticule Extraction (SMILE) procedure

Setting:

Department of Phaco and Refractive Surgery, Nethradhama Super Speciality Eye Hospital, Bangalore, India

Methods:

In case 1 the lenticule was torn and a central fragment was retained in the pocket. In case 2 the inferior part of the lenticule remained attached at the anterior plane and its detached, superior part was dislocated and folded at the inferior part of the pocket. In case 3 the lenticule was completely attached at the anterior plane. All cases were taken up for exploration. The lenticule fragment was detached using the dissector's body and tip and was extracted using advanced lenticule forceps. The retained lenticules were extracted after dissection of tissue bridges at the anterior plane and periphery.

Results:

Postoperatively all eyes showed improvement of visual acuity and topographic regularization of the anterior corneal curvature. Complete removal of lenticule remnants was accomplished in cases 1 and 2. In case 3 the photodisruption during primary SMILE was incomplete at a peripheral area next to the incision. After the lenticule removal, a small peripheral fragment, corresponding to the described peripheral area, remained attached and was left in situ, without, however, any impact on visual acuity and quality.

Conclusions:

Retained lenticules or lenticule fragments may induce irregular astigmatism and decrease of visual acuity. Their prompt removal restores visual acuity and induces the desired effect of the primary SMILE procedure.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented