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Post SMILE epithelial ingrowth far located from incision managed surgically

Poster Details

First Author: J.Saldaña Garrido SPAIN

Co Author(s):    B. Canizares Baos   P. Tana Rivero                 

Abstract Details


To pose the pathophysiology about epithelial ingrowth (EI) in small incision lenticule extraction SMILE and to assess the role of cryotherapy in its treatment.


Cataract and Refractive Unit, Oftalvist Clinic, Alicante, Comunidad Valenciana, Spain.


Case series of three cases of EI far located from incision after SMILE two of which required treatment with epithelial removing and cryotherapy after a period of following-up where progression was observed. Visual outcomes and the presence or absence of epitelial ingrowth were evaluated again after 3 months and at the last follow-up. The main outcome measures were recurrence of epitelial ingrowth and visual acuity.


three women without personal history got operated with SMILE technique, without incidents during the procedure. During the postoperative they developed grade 1 EI far from the incision in their right eye at infero-temporal and parapupillary area. Uncorrected distance visual acuity (UDVA) was 7/10. One of them didn�â�€�™t show progression but in two of them progression was observed and treatment was performed. After epithelial removing and cryotherapy, UDVA was 9/10 and 6/10 respectively and after two years of following-up and no recidive has been observed.


Despite it is a rare complication in SMILE, interface EI is a potential complication and it can occur far away from the incision, which can suggests that epithelial cells seeding is the most likely cause of epithelial ingrowth in SMILE. Normally no treatment is required but we must treat if any progression is observed. We suggest criotherapy in conjunction with manual epitelial removal as a effective method to stop and to prevent EI into the interface. Larger randomized studies are needed to compare the success of this technique with others.

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