This guide explains practical clinical details and scientific evidence for the SMILE (small incision lenticule
extraction) procedure for corneal refractive surgery, with description of preoperative assessment, surgical technique, and postoperative management.
We prefer implantation of phakic IOLs only in nonpresbyopic patients who are not suitable for corneal refractive surgery (mainly small incision lenticule
Assessment of corneal lenticule
: Heidelberg retina tomography-III, optical coherence tomography, and slit-lamp examination
Comparison of Visual Outcomes After Femtosecond LASIK, Wave Front-Guided Femtosecond LASIK, and Femtosecond Lenticule
Baudouin, "Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule
extraction versus LASIK," Ophthalmology, vol.
Other settings were as follows: spot energy was 140 nJ, minimum lenticule
edge thickness was 15 [micro]m, lenticule
sidecut angle was 120[degrees] and optical zone was 6.5 mm.
Acute rejection was associated with intense sector injection at the limbus, edema, and infiltration of the lenticule
, punctate keratopathy and epithelial defects.
The donor lenticule
was transferred endothelial side down onto the viscoelastic-coated Sheet glide (Figure 1(g)).
Descemet's stripping and automated endothelial keratoplasty uses a mechanical microkeratome to harvest the donor corneal lenticule
and mechanical stripping of the diseased host endothelium and Descemet's membrane (5).
It involves scraping away the thin outer layer of epithelial cells covering the cornea, then permanently attaching a refractiveM biocompatible corneal covering, or lenticule
. The lenticule
is made of chemically altered collagen, a naturally occurring protein.
The suitable types of laser vision correction discussed with the patient were laser-assisted epithelial keratomileusis (LASEK) and small incision lenticule
Since 2011, small incision lenticule
extraction using a femtosecond laser has become clinically available as an alternative to laser in situ keratomileusis .