CIRCLE Software for Management of Epithelial Ingrowth After SMILE.

Purpose: To report a novel therapeutic use of CIRCLE software (Carl Zeiss Meditec) to manage visually significant epithelial ingrowth following small incision lenticule extraction surgery (SMILE).

Methods: Case series.

Results: In this case series, the authors describe three eyes with progressive and visually significant epithelial ingrowth following an uneventful SMILE procedure. The management of epithelial ingrowth following SMILE is challenging, given the small access incision to the interface and the risk of incomplete removal. All cases were successfully managed by converting the SMILE cap into a flap using the CIRCLE software, which provided the necessary access to the original SMILE interface. Once the flap was lifted, the epithelial in-growth was completely debrided from the underlying stroma and undersurface of the flap, followed by a thorough interface wash. Postoperative recovery was uneventful, with no recurrence noted in any of the eyes.

Conclusions: Use of CIRCLE software provides a novel and unique approach to successfully treating vision-threatening epithelial ingrowth after SMILE. .