Ectasia After SMILE Lacking Perceivable Risk Factors

Abstract

PURPOSE: To describe 3 eyes from 2 patients who had corneal ectasia after small incision lenticule extraction (SMILE) without tangible risk factors. METHODS: A 27-year-old woman and a 24-year-old man with compound myopic astigmatism and normal corneal topographies underwent uneventful SMILE in both eyes. RESULTS: The first patient complained of decreased visual acuity 6 months after SMILE. She presented with uncorrected distance visual acuity (UDVA) of 20/60 and 20/200 in the right and left eyes, respectively. Topography revealed decreased thickness and inferior steepening in both eyes. The second patient presented at 5 years after SMILE with UDVA of 20/400 and 20/100 in his right and left eyes, respectively. Tomography revealed an inferior steepening in the right eye. These findings were compatible with post-refractive surgery ectasia. CONCLUSIONS: Even though SMILE is considered a safe procedure, it is not exempt from developing corneal ectasia even without evident risk factors, which implies the need for a strict preoperative evaluation. [ Journal of Refractive Surgery Case Reports. 2022;2(3):e63–e67.]