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Surgical management of epithelial ingrowth as a late complication after SMILE

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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


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


Department of Ophthalmology, Goethe University, Frankfurt, Germany


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.


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.


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.

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