Small Incision Lenticule Extraction (SMILE) in Patients with Corneal Guttae

To report 12-month results of small incision lenticule extraction (SMILE) in the treatment of myopia with corneal guttae (CG).

We conducted a retrospective analysis of 12 eyes from six patients who had preoperative CG without clinical sign of Fuchs' endothelial corneal dystrophy (FECD) and had SMILE for correction of myopia. Preoperative and 12-month postoperative measurements included uncorrected distance visual acuity (UDVA), spherical equivalent (SE), endothelial cell density (ECD), the coefficient of variation (CV), the percentage of hexagonal cells (HEX), and central corneal thickness (CCT). The changes in ECD, CV, HEX, and CCT after SMILE were subjected to statistical analysis.

Twelve months postoperatively, the mean SE was -0.10 ± 0.32 D and all eyes had a UDVA of 0 logMAR or better. No eyes developed corneal edema or other complication during the follow-up period. There were no significant changes in the ECD, CV, or HEX at 12 months (all p>0.05).

SMILE yielded improvement in visual acuity and no adverse effects to corneal endothelial cells were found when correcting myopia or myopic astigmatism in patients with CG. However, studies with a greater number of patients and longer follow-up periods are needed to establish the long-term outcomes and safety.