Long-term follow-up of bilateral ectasia after laser-assisted Small-Incision Lenticule Extraction (SMILE) with known risk factors.

Purpose: To report the long-term follow-up of bilateral ectasia after laser-assisted small-incision lenticule extraction (SMILE) with known risk factors.
Case Report: 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.
Conclusions: 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.