title: Recalcitrant Epithelial Ingrowth After SMILE Treated With a Hydrogel Ocular Sealant.
abstract: OBJECTIVE
  To report a case of recalcitrant epithelial ingrowth after small incision lenticule extraction (SMILE) treated successfully with a novel hydrogel ocular sealant.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  A 32-year-old man who underwent small incision lenticule extraction (SMILE) complicated by difficult lenticule extraction developed visually significant epithelial ingrowth. He then underwent two flap lifts and epithelial scrapings and flap edge suturing with recurrence of epithelial ingrowth despite these interventions. He subsequently underwent repeat scraping, followed by hydrogel ocular sealant placement (ReSure Sealant; Ocular Therapeutix, Inc., Bedford, MA), which prevented recurrence of epithelial ingrowth and reduced corneal haze. The patient was also found to have undiagnosed diabetes, suggesting that just as in LASIK, diabetes may be a risk factor for epithelial ingrowth after SMILE.
  
  
  CONCLUSIONS
  Interface epithelial ingrowth is a potential complication after SMILE and diabetes may be a risk factor for this complication. Hydrogel ocular sealant may be effective after SMILE to prevent epithelial ingrowth into the interface.
authors.forename: Praneetha
authors.initials: P
authors.lastname: Thulasi
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
authors.forename: J Bradley
authors.initials: JB
authors.lastname: Randleman
mesh_terms: D000328:Adult; D003316:Corneal Diseases / Q000209:etiology* / Q000601:surgery; D003319:Corneal Stroma / Q000473:pathology* / Q000601:surgery*; D019781:Corneal Topography; D004847:Epithelial Cells / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000627:therapeutic use*; D008297:Male; D012008:Recurrence; D054140:Refractive Surgical Procedures / Q000009:adverse effects*; D013524:Surgical Flaps; D014014:Tissue Adhesives / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence
chemical_list: D014014:Tissue Adhesives; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate