Management of residual lenticule and irregular astigmatism after small incision lenticule extraction

We report a case of a retained lenticule and irregular corneal astigmatism after small-incision lenticule extraction (SMILE) and successful extraction of the residual lenticule 2 months later. Slitlamp examination showed a residual lenticule 1 week after small-incision lenticule extraction. There was a loss of 3 lines of corrected distance visual acuity (CDVA). Corneal topography showed nasal steepening and irregular astigmatism. The presence of the lenticule was confirmed with spectral-domain optical coherence tomography. The CDVA did not improve during the 2-month follow-up. The retained lenticule was successfully extracted 2 months postoperatively. One month after the extraction of the retained small lenticule, the uncorrected distance visual acuity improved to the level of the preoperative CDVA. Slitlamp examination showed a clear cornea, and the anterior corneal curvature was regular on corneal topography.