Epithelial-related complications more prevalent in older patients after recovery from SMILE
Small incision lenticule extraction (SMILE) is a laser refractive surgery to correct myopia. Using a femtosecond laser, a small intrastromal lenticule is created and manually extracted through a small incision. Unlike other refractive surgical techniques, SMILE does not involve the creation of a corneal flap, providing several advantages over laser assisted in situ keratomileusis (LASIK) with respect to managing postoperative corneal-related complications. Although epithelial-related complications after LASIK have been described in several studies, the incidence of epithelial-related complications following SMILE is not as well documented. The study by Moshirfar et al reported a single-site five-year experience with the incidence and management of only epithelial-related complications after SMILE.
A retrospective, single-site study analyzed patients who underwent SMILE at Hoopes Vision Clinic in Draper, Utah, from June 2017 to February 2023. Demographic data and preoperative parameters were reviewed. Postoperatively, patients were assessed for visual acuity and complications at different time points. Statistical analyses were conducted between the control and complication groups.
Four hundred and thirty-two eyes of 220 patients received SMILE. Postoperative epithelial-related complications were indicated in 68 (15.7%) eyes, including anterior basement membrane (ABM) changes (five [1.2%]) eyes), epithelial ingrowth (nine [2.1%] eyes), erosion (two [0.5%] eyes), rough epithelium (18 [4.2%] eyes), epithelial defect (12 [2.8%] eyes), diffuse lamellar keratitis (DLK) secondary to epitheliopathy (two [0.5%] eyes), microstriae secondary to epitheliopathy (four [0.9%] eyes), interface debris (21 [4.9%] eyes), and incisional fibrosis (one [0.2%] eye).
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