ABSTRACT
PURPOSE: The purpose of this study was to report a case of bilateral ectasia 3 years after small incision lenticule extraction (SMILE) in a patient with normal preoperative topography of the right eye and abnormal topography of the left eye. METHODS: This study was a case report. RESULTS: A 22-year-old man developed bilateral corneal ectasia after SMILE. The preoperative corneal topography of the right eye was unremarkable, with a minimum corneal thickness of 511 µm in the right eye, and the abnormal corneal topography of the left eye revealed a risk factor for developing ectasia, with a minimum corneal thickness of 514 µm in the left eye. The refractive error was -4.50 to 3.50 × 10 degrees in his right eye and -4.25 to 3.50 × 0 degrees in his left eye with a best-corrected visual acuity of 20/20. An uncomplicated SMILE was performed; after his last follow-up visit at 1 month, the patient was lost to follow-up for 3 years. After that time, he presented with visual loss with left predominance. Bilateral ectasia was diagnosed through corneal topography, and crosslinking was performed in both eyes. CONCLUSIONS: There are a very few reports of corneal ectasia after SMILE with normal preoperative topography.