Clinical Outcomes Of Epithelial Basement Membrane Dystrophy After Small Incision Lenticule Extraction

This study was performed to determine the clinical outcomes of small incision lenticule extraction (SMILE) in eyes with epithelial basement membrane dystrophy (EBMD) that initially developed after surgery.

Onnuri Smile Eye Clinic, Seoul, Korea, Republic of

This retrospective study reviewed the medical records of 26 eyes of 18 patients who exhibited normal corneas before surgery and signs of EBMD after SMILE. Intraoperative findings and postoperative corneal abnormalities were recorded, and visual outcomes were evaluated. The follow-up interval was 3 months.

Signs of corneal epithelial weakness were observed intraoperatively in 53.8% of eyes. Signs of EBMD were first observed between 1 day and 1 week postoperatively in 84.6% of eyes: 23.1% showed epithelial defects, 38.5% showed subepithelial opacity, 19.2% showed diffuse lamellar keratitis, and 3.9% showed epithelial ingrowth. Symptoms while corneal lesions were present occurred in 76.9% of eyes. At 3 months postoperatively, 80.8% of eyes showed no specific findings on slit-lamp microscopy after medical treatment, 7.7% of eyes showed subepithelial opacity and 7.7% of eyes showed diffuse corneal scar. Uncorrected distance visual acuity was 20/25 or better in 92.3% of eyes, and spherical equivalent was within ± 1.0 D in 76.9% of eyes.

When EBMD developed after SMILE, favorable results were obtained with appropriate nonsurgical treatment. However, caution is required because EBMD can cause discomfort during the healing phase; it can also lead to long-term complications, such as corneal scarring.