# Interface fluid syndrome caused by the corneal perforation injury after small incision lenticule extraction: a case report

## TL;DR

A woman who had SMILE surgery developed interface fluid syndrome after a corneal injury, which was successfully treated with iOCT-guided repair.

## Contribution

This case report highlights interface fluid syndrome as a rare complication of corneal perforation after SMILE surgery.

## Key findings

- Interface fluid syndrome occurred after corneal perforation repair following SMILE.
- Intraoperative optical coherence tomography guided successful resuturing and improved visual acuity.

## Abstract

To report a case of interface fluid syndrome (IFS) following traumatic corneal perforation repair after small incision lenticule extraction (SMILE).

A 23-year-old woman, with a past history of SMILE, was struck in the left eye with a barbecue prod and subsequently underwent corneal perforation repair at local hospital. Primary wound repaired with a single 10 − 0 nylon suture at the area of leakage. After the surgery, her best corrected visual acuity (BCVA) was 20/30. Four days later, she presented at our hospital with blurred vision, and interface fluid syndrome (IFS) was diagnosed. Intraoperative optical coherence tomography (iOCT) was used to guide the resuturing of the corneal perforation in the left eye, followed by anterior chamber gas injection. At the first postoperative month, the BCVA was 20/25. The corneal cap adhered closely to the stroma, the surface became smooth.

This case illustrates that any corneal perforation following lamellar surgery, including SMILE, may lead to IFS. It is crucial to consider the depth of corneal perforation, and intraoperative optical coherence tomography (iOCT) plays a unique role in the repair procedure.