Application Of The Smile Lenticule In Corneal Tear Repair- A Case Report

To report a case of corneal tear which was repaired with SMILE extracted lenticule.

Corneal foreign bodies are common ocular emergencies reported in ophthalmology emergency. Small incision lenticule extraction (SMILE) is an advanced femtosecond laser refractive technique used to correct myopia and myopic astigmatism through extraction of an intrastromal corneal lenticule without a corneal flap. As the SMILE-extracted lenticule is removed as a single slice, it can be re-implanted for the treatment of corneal perforations. 

A 24 year old male had a of injury to his right eye by metal (iron) piece while cutting the iron sheet. On slit lamp examination, it revealed a deep intrastromal foreign body at 1 ‘o clock position paracentrally away from pupillary area with surrounding stromal edema in the right eye.

An ASOCT was done which showed deep foreign body embedded in the deep stroma but not intruding in to the anterior chamber.

The patient was taken for foreign body removal under local anaesthesia. He underwent foreign body removal with CAG was sutured and BCL was placed. On POD1, tear was repaired well and CAG was on place and the anterior chamber was well formed.

After 4 months, suture removal was done. Following which Anterior chamber was not formed, so was then planned for SMILE lenticule plug.

On first post op day, SMILE lenticule was insitu, AC was well formed. UCVA was 6/24.

The lenticule patch graft seems to serve as a safe, feasible, and inexpensive surgical option for the treatment of keratohelcosis or partial-thickness corneal defects, especially in small perforation and defects. There are hopeful signs that SMILE-derived lenticule becomes a potential graft for therapeutic keratoplasty.