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Diffuse lamellar keratitis after small incision lenticule extraction: presumably related to meibomian gland dysfunction
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Sang Beom Han
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Insights Cataract Refract Surg 2025;10(2):61-64. Published online June 30, 2025
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DOI: https://doi.org/10.63375/icrs.25.008
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 Abstract
 PDF ePub
- Purpose
This report presents a case of diffuse lamellar keratitis (DLK) after femtosecond laser-assisted small incision lenticule extraction (SMILE). The case was presumably associated with meibomian gland dysfunction (MGD).
Case
summary: A 25-year-old male patient underwent SMILE surgery. Preoperative examination revealed MGD in both eyes. Despite vigorous cleaning of the eyelid margin and irrigation of the ocular surface, meibomian gland secretion floating on the ocular surface was observed after the lenticule extraction in the right eye. At 2 days postoperatively, stage I DLK was detected. After aggressive topical steroid treatment, the DLK completely resolved without any sequalae.
Conclusion
DLK can occur in association with MGD. Attention should be paid when performing SMILE in eyes with MGD.
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Selection of an optimal intraocular lens according to the stage of epiretinal membrane
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Sang Beom Han
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Insights Cataract Refract Surg 2025;10(1):7-12. Published online February 28, 2025
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DOI: https://doi.org/10.63375/icrs.25.003
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Abstract
PDFePub
- Epiretinal membrane (ERM), one of the most common retinal diseases, can cause various degrees of visual disturbance, reduced contrast sensitivity, and metamorphopsia. ERM is not infrequently encountered during preoperative evaluations for cataract surgery, and selecting an appropriate intraocular lens (IOL) according to the location and stage of ERM is necessary in order to improve visual outcomes and patients’ satisfaction. This review summarizes the application of various IOLs—such as multifocal, extended depth of focus, and enhanced monofocal IOLs—in eyes with ERM, and discusses the selection of an appropriate IOL.
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Large incisional tear caused by abrupt Bell’s phenomenon during pocket irrigation in femtosecond laser-assisted small incision lenticule extraction
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Sang Beom Han
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Received December 22, 2025 Accepted January 5, 2026 Published online January 21, 2026
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DOI: https://doi.org/10.63375/icrs.25.015
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Abstract
- Purpose
This study reports a case of a large incisional tear caused by abrupt Bell’s phenomenon during pocket irrigation in femtosecond laser-assisted small incision lenticule extraction (SMILE).
Case
summary: A 28-year-old male patient underwent SMILE surgery. During pocket irrigation of the right eye, Bell’s phenomenon suddenly occurred, resulting in a large inferior arcuate extension of the incision that reached the inferior cap margin. After confirming wound integrity and the absence of additional tissue damage, a bandage contact lens was applied. On postoperative day 7, the incision was self-sealed with intact wound integrity. Three months postoperatively, uncorrected distance visual acuity was 20/20 in both eyes. The right cornea remained stable, although a faint residual scar was observed at the site of the incisional tear.
Conclusion
Abrupt eye movements during pocket irrigation in SMILE can cause large incisional tears. Surgeons should exercise heightened vigilance during irrigation, particularly in anxious or uncooperative patients, to prevent such complications.
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