Shifting "Ectasia": Interface Fluid Collection After Small Incision Lenticule Extraction (SMILE).

PURPOSE: 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.].