title: Unusual Severe Interface Inflammation After Uneventful Small Incision Lenticule Extraction (SMILE).
abstract: OBJECTIVE
  To describe a 40-year-old woman who complained of visual loss in her left eye 3 days after an uneventful bilateral myopic refractive surgery by small incision lenticule extraction (SMILE).
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 4 × 5 mm anterior central stromal infiltration was observed with moderate pain associated with decreased corneal sensitivity and neither discharge nor fluorescein staining. Bacterial and fungal smears and cultures from the SMILE interface were negative and local antibiotic ineffective. She was subsequently treated with peribulbar dexamethasone injections and oral valacyclovir. Corneal infiltration disappeared progressively, replaced by fibrotic stromal scarring. Optical coherence tomography displayed stromal hyperreflectivity mostly located above the lenticule cut with slight involvement of posterior stroma. In vivo confocal microscopy demonstrated activated keratocytes and highlighted the lack of subbasal corneal nerves in her left eye contrasting with her right eye.
  
  
  CONCLUSIONS
  Stromal herpetic keratitis could be considered a potential differential diagnosis to this atypical lamellar keratitis after a SMILE procedure. [J Refract Surg. 2016;32(12):855-857.].
authors.forename: Damien
authors.initials: D
authors.lastname: Guindolet
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Badaoui
authors.forename: Maud
authors.initials: M
authors.lastname: Elluard
authors.forename: Sophie
authors.initials: S
authors.lastname: Stephan
authors.forename: Serge
authors.initials: S
authors.lastname: Doan
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cochereau
authors.forename: Eric E
authors.initials: EE
authors.lastname: Gabison
mesh_terms: D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D015590:Fluorophotometry; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018613:Microscopy, Confocal; D009216:Myopia / Q000601:surgery*; D041623:Tomography, Optical Coherence; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir