Customized wavefront-optimized transepithelial photorefractive keratectomy for a retained lenticule fragment after primary SMILE

Purpose: To describe the surgical outcomes after transepithelial photorefractive keratectomy (PRK) for a case of retained intrastromal lenticule fragment after small incision lenticule extraction (SMILE). Methods: Transepithelial PRK was performed to minimize corneal irregularity and to correct residual refractive errors in a patient who had undergone failed lenticule extraction, which resulted in a refractive lenticule fragment being retained for 14 months after primary SMILE. Results: At the postoperative 6-month visit, uncorrected distance visual acuity and corrected distance visual acuity improved to 20/20 and 20/20, respectively, and corneal tomography depicted normalization of the corneal surface. Corneal higher order aberrations, including coma, trefoil, and spherical aberration, were markedly reduced. Conclusions: Transepithelial PRK is a potential option for the management of a retained lenticule fragment after primary SMILE.