Myopic outcome after intraocular lens implantation in a patient who previously had small-incision lenticule extraction

Introduction: This is a report of cataract surgery in a post–small-incision lenticule extraction (SMILE) patient with low myopia. Patient and clinical findings: A 49-year-old man underwent bilateral SMILE 18 months previously, and the visual acuity of both eyes recovered to 20/20. The patient noticed a gradual reduction in visual acuity in his left eye and blurring for 3 months. The corrected distance visual acuity (CDVA) was 20/67 in his left eye. Diagnosis, intervention, and outcomes: The slitlamp examination revealed an anterior subcapsular cataract. The intraocular lens (IOL) power was calculated by using a multiformula averaging method. A standard femtosecond laser–assisted phacoemulsification cataract surgery was performed and a trifocal IOL implanted. 2 months after IOL implantation, the uncorrected distance visual acuity of the left eye was 20/33, the autorefraction values were −1.37 −0.25 × 146, and the CDVA was 20/20. Conclusions: This case report showed that current postrefractive IOL power calculation formulas or methods may lead to myopic outcomes in patients who previously received SMILE. A standard IOL calculation may be more suitable for such patients. Additional case studies are needed to accurately calculate IOL power after SMILE similar to laser in situ keratomileusis.