Posters

Case report: Managing an unextracted lenticule during ReLex SMILE due to a false plane dissection

Poster Details

First Author: O.Wolter NETHERLANDS

Co Author(s):    M. Versteegh   E. Timmerman   H. Ockels   I. Nijdam           

Abstract Details

Purpose:

Case report of a challenging case in a rare SMILE complication of a non-extracted lenticule due to a false plane dissection. The Circle Mode was used to create a new side cut to remove the retained lenticule. The visual acuity and safety result will be presented.

Setting:

Oogheelkundig Medisch Centrum Hanze Kliniek Groningen - The Netherlands

Methods:

A ReLEx SMILE for myopic astigmatism was performed on the left eye of a 22 years old female. A false plane dissection occurred and it was not possible to remove the lenticule. A plan of treatment was made to remove the lenticule at 4 Months post-op; creating a new side cut using the Circle Mode of the VisuMax Zeiss 500 FS laser platform to remove the retained lenticule in combination with the primary side cut.

Results:

ReLEx SMILE Treatment: Sph. -4,00 Cyl. -1,00 axis 175   BCVA 1,0+ CAP data: 120 mm x 7,10 mm Lenticule data:             Lenticule 6,0 mm, Transition zone 0.1 Side Cut:              55 Degrees and 3,0 mm                    RST: 299 Circle Mode  Manifest: Sph. -5,00 Cyl. -2,00 axis 10    BCVA 0,7 Lamellar side cut:         Diameter 6,80 mm and depth 130 mm Side Cut only:  125 degrees and 3 mm It was possible to avoid the false plane dissection and to remove the lenticule successfully using the primary and secondary side cut. UCVA recovered to 0,9 and BCVA 1,0- S+0,25 C-0,75 axis 170 after 3 months.

Conclusions:

SMILE false plane is a rare complication. Lenticule removal after a false plane dissection was possible using the primary side cut at 55 degrees and creating a secondary new side cut at 125 degrees with the Circle Mode, avoiding the original false plane. The procedure was safe and visual acuity recovered well. Removing a retained lenticule after a false plane dissection in SMILE will reduce irregular astigmatism, corneal scarring and BCVA loss.

Financial Disclosure:

None