Goupillou Paul, Boutillier Guillaume, Naguszewski Dominique, Muraine Marc
Rouen University Hospital, France.
Immeuble Copernic, Fleury Sur Orne, France.
Eur J Ophthalmol. 2023 May;33(3):NP14-NP17. doi: 10.1177/11206721221085397. Epub 2022 Mar 2.
To report the long-term follow-up of bilateral ectasia after laser-assisted small-incision lenticule extraction (SMILE) with known risk factors.
We report the case of a 23-year-old woman. Preoperative refraction was - 7.25 -2.00 × 20 in the right eye and -7.25 -1.50 × 155 in the left eye. Maximal keratometry was 47.32 diopters and 48.37 diopters, respectively, which was a contraindication to Laser Assisted In Situ Keratomileusis (LASIK) and a SMILE was proposed in 2015. One year after surgery, ectasia developed in the left eye and crosslinking (CXL) was performed. Two years after surgery, ectasia also developed in the right eye and CXL was also performed, leading to stabilization in both eyes five years after surgery.
Known contraindications for LASIK are also contraindications for the performance of refractive surgery with SMILE. CXL is an efficient treatment of post-SMILE corneal ectasia.
报告已知风险因素下准分子激光微小切口基质透镜切除术（SMILE）后双侧角膜扩张的长期随访情况。
我们报告一名23岁女性的病例。术前右眼验光结果为-7.25 -2.00×20，左眼为-7.25 -1.50×155。最大角膜曲率分别为47.32屈光度和48.37屈光度，这是准分子原位角膜磨镶术（LASIK）的禁忌证，因此在2015年建议行SMILE手术。术后一年，左眼出现角膜扩张并进行了交联（CXL）治疗。术后两年，右眼也出现角膜扩张并同样进行了CXL治疗，术后五年双眼病情稳定。
LASIK已知的禁忌证也是SMILE屈光手术的禁忌证。CXL是治疗SMILE术后角膜扩张的有效方法。
