Corneal Abrasion Risks in SMILE Laser Surgery: What to Know - Ophthalmology

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Corneal abrasion is a potential risk associated with any type of laser eye surgery, including SMILE (Small Incision Lenticule Extraction) laser surgery. Understanding the risks and how to manage them is crucial for ensuring a smooth recovery and optimal visual outcomes.

During the SMILE procedure, a laser is used to create a small lenticule (a disc-shaped piece of tissue) within the cornea, which is then removed through a small incision. While the procedure is designed to minimize trauma to the cornea, there are still risks of corneal abrasions, particularly if the laser settings are not precisely calibrated or if there is any movement during the procedure. Abrasions can also occur post-operatively due to improper handling of the eye or exposure to irritants.

If you experience a corneal abrasion, it can lead to symptoms such as pain, redness, tearing, and blurred vision. In your case, with one eye experiencing significant blurriness and the other eye maintaining better vision, it is essential to address this issue promptly. Here are some steps you can take:
1. Consult Your Eye Surgeon: The first and most important step is to contact your eye surgeon or ophthalmologist. They can perform a thorough examination to assess the extent of the abrasion and determine the best course of action. They may use fluorescein dye to highlight the abrasion during the examination.

2. Avoid Rubbing Your Eyes: Rubbing can exacerbate the abrasion and lead to further complications. It is crucial to keep your hands away from your eyes.

3. Use Prescribed Eye Drops: Your doctor may prescribe antibiotic eye drops to prevent infection and lubricating drops to help soothe the eye. Follow their instructions carefully regarding dosage and frequency.

4. Rest Your Eyes: Limit screen time and other activities that may strain your eyes. Give your eyes time to heal.

5. Follow-Up Appointments: Attend all follow-up appointments as scheduled. Your doctor will monitor the healing process and make any necessary adjustments to your treatment plan.

6. Avoid Contact Lenses: If you wear contact lenses, you should avoid using them until your eye has fully healed. This can help prevent further irritation or complications.

7. Monitor Symptoms: Keep an eye on your symptoms. If you notice increased pain, worsening vision, or any signs of infection (such as discharge or increased redness), seek medical attention immediately.

Regarding your concern about whether the epithelium needs to be scraped off to promote healing, this is typically not necessary for minor abrasions. The cornea has a remarkable ability to heal itself, and most abrasions will heal within a few days with proper care. Your eye care professional will guide you on the best approach based on the severity of your condition.

In terms of the significant difference in vision between your two eyes (aniseikonia), this can occur after laser surgery due to differences in healing or refractive outcomes. Your eye doctor can provide options to address this, which may include additional treatments or corrective lenses.

In summary, while corneal abrasions can occur during SMILE laser surgery, prompt attention and appropriate care can lead to successful healing and restoration of vision. Always prioritize communication with your healthcare provider to ensure the best outcomes for your eye health.