Shifting "Ectasia": Interface Fluid Collection After Small Incision Lenticule Extraction (SMILE).
OBJECTIVE
To report the first case and a new diagnostic sign of interface fluid collection following small incision lenticule extraction (SMILE).


METHODS
Case report.


RESULTS
A 20-year-old man underwent SMILE for correction of compound myopic astigmatism. Postoperative follow-up examination included vision testing, slit-lamp examination, intraocular pressure measurement, corneal topography, and optical coherence tomography (OCT). The patient presented postoperatively with decreased vision in his right eye. Topography revealed an island of corneal steepening, the location of which kept shifting on successive visits. OCT revealed the presence of fluid pockets in the interface. The condition resolved with topical hypertonic saline and the uncorrected visual acuity recovered to 20/20. The intraocular pressure remained normal throughout.


CONCLUSIONS
This is the first case report of interface fluid collection after SMILE. The report demonstrates shifting corneal "ectasia" (steepening) as a diagnostic sign of interface fluid collection. The authors recommend a new pathogenesis for this condition and suggest the use of topical hypertonic saline to treat this condition. [J Refract Surg. 2016;32(11):773-775.].
Aashish K
AK
Bansal
Somasheila I
SI
Murthy
Syed M
SM
Maaz
Mahipal S
MS
Sachdev
D000287:Administration, Topical; D001251:Astigmatism / Q000601:surgery*; D003316:Corneal Diseases / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism*; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000601:surgery; D048988:Corneal Surgery, Laser / Q000379:methods; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D045604:Extracellular Fluid / Q000502:physiology*; D006801:Humans; D057446:Hydrodynamics; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D009883:Ophthalmic Solutions; D012462:Saline Solution, Hypertonic