Abstract： Objective: To investigate clinical treatment for lens residue after femtosecond laser small incision lenticule extraction (SMILE). Methods: Retrospective cases series study. A total of 288 patients (557 eyes) who underwent SMILE surgery in Weifang Eye Hospital from August 1 to 29, 2020 were selected for routine perioperative management. The lenticule residual retained was recorded postoperatively. Results: Two hundred eighty-eight patients (557 eyes) underwent surgery. Uncorrected visual acuity 1 day after surgery was -0.2-0.2, with an average of -0.026±0.075 (LogMAR). One month after surgery, the visual acuity of the naked eye was -0.2-0.2, with an average of -0.062±0.055 (LogMAR). The residual spherical equivalent refractive errors were -1.00-+1.00 D on the 1st day after surgery, with an average of +0.11±0.43 D. The residual spherical equivalent refractive errors were -1.00-+1.00 D one month after surgery, with an average of +0.20±0.36 D. There was lenticule residual retention in 6 eyes (1%). Among the cases with lenticule residual retention, 4 eyes had good visual acuity and the residual was in a short strip close to the peripheral area. The visual acuity of one naked eye was 1.0, but the postoperative residual refractive index was large. Pentacam showed corneal irregularity and the lenticule residual retention could be observed with anterior segment optical coherence tomography (AS-OCT). Then a secondary extraction was performed. One eye lost suction when the lenticule edge cut was completed; suction was restored immediately and laser scanning was completed. However, the lenticule separation and removal was difficult. The visual acuity of the naked eye was poor postoperatively. Pentacam showed corneal irregularity and AS-OCT showed the lenticule residual retained. The patient refused further treatment and was followed up. Conclusions: SMILE has a low incidence of partially retained lenticule. Satisfactory results can still be obtained by proper disposal of residual lenses.
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