Corneal opacities after small-incision lenticule extraction. 2022

Serdar Kartal, and Rudy M M A Nuijts, and Jesper Hjortdal, and Sheraz Daya, and Eung Kweon Kim, and Walter Sekundo, and Sri Ganesh, and Sheetal Brar, and Majid Moshirfar, and Annika M Hansen, and Carter J Payne
Maastricht, the Netherlands.

A 36-year-old woman was referred to our clinic in October 2021 with suboptimal vision at intermediate and near distances and halos and photophobia after a small-incision lenticule extraction (SMILE) in December 2019. The patient needs to increase font size of her computer to 150% to read text, but images still appear blurred. She indicates that sunglasses seem to improve her contrast. Preoperatively, her refractive error was -2.5 diopters (D) and -2.25 D for right and left eyes. The optical zone size of the SMILE procedure was 6.8 mm. There is no further information available on the peroperative course of the SMILE procedure. Her uncorrected distance visual acuity (UDVA) is 20/20 in both eyes and does not improve with correction. The Schirmer tear test is 14 to 13 mm. Slitlamp biomicroscopy of the right eye and the left eye reveals hyperreflective small opacities in the anterior one-third of the corneal stroma ( Figures 1 and 2JOURNAL/jcrs/04.03/02158034-202209000-00021/figure1/v/2022-08-29T115553Z/r/image-tiffJOURNAL/jcrs/04.03/02158034-202209000-00021/figure2/v/2022-08-29T115553Z/r/image-tiff ). No other abnormalities are seen. The scotopic pupil sizes are 6.41 and 6.73 mm. Straylight measurements are within normal limits. Higher-order aberrations (HOAs) measure for the right eye (6.03 mm pupil) 0.818 μm and for the left eye (6.17 mm pupil) 0.560 μm. The corneal Scheimpflug tomography quad maps for both eyes are shown in Supplemental Figures 1 and 2 ( http://links.lww.com/JRS/A663 , http://links.lww.com/JRS/A664 ). What is your diagnosis or are additional diagnostic methodologies needed to establish a diagnosis? What is your treatment advice for this patient?

UI MeSH Term Description Entries
D009216 Myopia A refractive error in which rays of light entering the EYE parallel to the optic axis are brought to a focus in front of the RETINA when accommodation (ACCOMMODATION, OCULAR) is relaxed. This results from an overly curved CORNEA or from the eyeball being too long from front to back. It is also called nearsightedness. Nearsightedness,Myopias,Nearsightednesses
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D003318 Corneal Opacity Disorder occurring in the central or peripheral area of the cornea. The usual degree of transparency becomes relatively opaque. Leukoma,Corneal Opacities,Leukomas,Opacities, Corneal,Opacity, Corneal
D003319 Corneal Stroma The lamellated connective tissue constituting the thickest layer of the cornea between the Bowman and Descemet membranes. Corneal Stromas,Stroma, Corneal,Stromas, Corneal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D048988 Corneal Surgery, Laser Surgical techniques on the CORNEA employing LASERS, especially for reshaping the CORNEA to correct REFRACTIVE ERRORS. Keratectomy, Laser,Laser Corneal Surgery,Laser Keratectomy,Photokeratectomy,Corneal Surgeries, Laser,Keratectomies, Laser,Laser Corneal Surgeries,Laser Keratectomies,Photokeratectomies,Surgeries, Laser Corneal,Surgery, Laser Corneal
D054018 Lasers, Excimer Gas lasers with excited dimers (i.e., excimers) as the active medium. The most commonly used are rare gas monohalides (e.g., argon fluoride, xenon chloride). Their principal emission wavelengths are in the ultraviolet range and depend on the monohalide used (e.g., 193 nm for ArF, 308 nm for Xe Cl). These lasers are operated in pulsed and Q-switched modes and used in photoablative decomposition involving actual removal of tissue. (UMDNS, 2005) Argon Fluoride Excimer Lasers,Excimer Lasers,Krypton Chloride Excimer Lasers,Xenon Chloride Excimer Lasers,ArF Excimer Lasers,ArF Lasers,Argon Fluoride Lasers,Excimer Laser,Excimer Lasers, ArF,Excimer Lasers, Argon Fluoride,Excimer Lasers, KrCl,Excimer Lasers, Krypton Chloride,Excimer Lasers, XeCl,Excimer Lasers, Xenon Chloride,KrCl Excimer Lasers,Krypton Chloride Lasers,Lasers, ArF Excimer,Lasers, Argon Fluoride Excimer,Lasers, KrCl,Lasers, Krypton Chloride,Lasers, Krypton Chloride Excimer,Lasers, XeCl Excimer,Lasers, Xenon Chloride,Lasers, Xenon Chloride Excimer,XeCl Lasers,Xenon Chloride Lasers,ArF Excimer Laser,ArF Laser,Argon Fluoride Laser,Chloride Laser, Krypton,Chloride Laser, Xenon,Chloride Lasers, Krypton,Chloride Lasers, Xenon,Excimer Laser, ArF,Excimer Laser, KrCl,Excimer Laser, XeCl,Fluoride Laser, Argon,Fluoride Lasers, Argon,KrCl Excimer Laser,KrCl Laser,KrCl Lasers,Krypton Chloride Laser,Laser, ArF,Laser, ArF Excimer,Laser, Argon Fluoride,Laser, Excimer,Laser, KrCl,Laser, KrCl Excimer,Laser, Krypton Chloride,Laser, XeCl,Laser, XeCl Excimer,Laser, Xenon Chloride,Lasers, ArF,Lasers, Argon Fluoride,Lasers, KrCl Excimer,Lasers, XeCl,XeCl Excimer Laser,XeCl Excimer Lasers,XeCl Laser,Xenon Chloride Laser

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