Surgical management of epithelial ingrowth as a late complication after SMILE

Session Details

Session Title: Presented Poster Session: Refractive Surgery New Techniques/Instrumentation/Devices II

Venue: Poster Village: Pod 2

First Author: : W.Glatz AUSTRIA

Co Author(s): :    G. Steinwender   M. Shajari   T. Kohnen                 

Abstract Details

Purpose:

Small incision lenticule extraction (SMILE) is a flapless procedure for the surgical treatment of myopia and astigmatism. Epithelial ingrowth is an uncommon complication which may lead to decreased vision in the postoperative course. Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany

Setting:

Department of Ophthalmology, Goethe University, Frankfurt, Germany

Methods:

A 34-year old woman suffered from blurred vision in her right eye and recognized a white dot on her cornea since 2 days. She had a previous history of extramural SMILE surgery 2 years ago to correct a refraction of -2.0 diopters (D) on the right eye and -4.0 D on the left eye. At presentation, UCVA was 20/63 on the right and 20/20 on the left eye, and CDVA was 20/25 on the right eye with refractive astigmatism of -1,75 D at 57°. Slit lamp examination revealed a superotemporal peripheral whitish opaque lesion with an extension of 3x3mm.

Results:

Because of increasing visual impairment due to epithelial ingrowth and induced irregular astigmatism on topography decision for an operative intervention was made. After reopening the pre-existing incision at 80° the epithelial island was removed meticulously with a spatula, followed by irrigation of the interface with antibiotics and cortisone. During the following week VA improved to UCVA 20/20. Until end of follow-up of 12 months no recurrence occurred.

Conclusions:

Epithelial ingrowth is a rare late complication after SMILE surgery, which can be successfully managed by surgical removal of epithelial cells through the pre-existing incisions.

Financial Disclosure:

None