Two cases of epithelial ingrowth after small incision lenticule extraction.

To report two cases of epithelial ingrowth after small incision lenticule extraction (SMILE) successfully treated without lifting the corneal cap. A 34-year-old woman and a 37-year-old man who both had undergone bilateral SMILE procedures earlier at another institution, developed visually significant epithelial ingrowth into the interface pocket with an incisional tear. In both patients, the interface pocket was meticulously irrigated with a balanced salt solution to facilitate separation of the epithelial ingrowth from the interface. After that, the epithelial ingrowth was manually scraped using a blunt spatula, and removed from the pocket using 27-gauge vitreous forceps. 10-0 nylon sutures and soft bandage contact lenses were placed for 1 week. The best spectacle-corrected visual acuity improved to 20/16 or more 1-month postoperatively. No significant complications occurred. SMILE with incisional tear may cause epithelial ingrowth, resulting in significant visual disturbance. This can be successfully treated with meticulous surgical debridement of the corneal epithelium, even without lifting the corneal cap.

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© 2020 The Authors.

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The following authors have no financial disclosures: MT, SN. 10.13039/501100003170KK reports personal fees from STAAR Surgical, personal fees from 10.13039/501100002806Carl Zeiss Meditec AG, personal fees from 10.13039/501100004286Santen Pharmaceutical, personal fees from Senjyu Pharmaceutical, personal fees from 10.13039/100006116AMO, personal fees from 10.13039/100015993Kowa Company, personal fees from 10.13039/501100007132Otsuka Pharmaceutical, outside the submitted work. NS reports grants, personal fees and non-financial support from Tomey Corporation, non-financial support from RE Medical Inc., during the conduct of the study; grants and personal fees from 10.13039/100015993Kowa Company, grants and personal fees from 10.13039/501100007132Otsuka Pharmaceutical, grants and personal fees from 10.13039/501100004286Santen Pharmaceutical, grants from Chuo Sangyo Company, grants from HOYA Corporation, grants from 10.13039/100007816Alcon Japan Ltd., grants and personal fees from 10.13039/100007816Alcon Pharmaceuticals, grants and personal fees from Senjyu Pharmaceutical, grants from Ogura Inc., grants and personal fees from 10.13039/100010793Pfizer Japan Inc., outside the submitted work. All authors attest that they meet the current ICMJE criteria for authorship.