Irregular astigmatism after femtosecond laser refractive lenticule extraction

We report a case of irregular corneal astigmatism after refractive lenticule extraction. A refractive lenticule was created using a femtosecond laser and then extracted through a small arcuate incision. One day postoperatively, the corneal findings by slitlamp biomicroscopy indicated mild corneal edema. Corneal topography demonstrated an area of steepened corneal surface inferiorly, and corneal thickness was relatively thicker in this area than in others. At 5 months, the corneal findings were normal by slitlamp biomicroscopy but corneal topography results remained unchanged. Fourier-domain optical coherence tomography examination showed remnant intrastromal lenticule tissue in this affected area. To our knowledge, this is the first case of residue intrastromal lenticule after refractive lenticule extraction. To prevent this complication, we believe it is important to completely dissect the lenticule and carefully examine the intactness of the lenticule during the surgery. (C) 2013 ASCRS and ESCRS