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The pilot study of re-use of small incision lenticule extraction (SMILE) lenticule: a preliminary report of epikeratophakia technique combined with Phototherapeutic Keratectomy (PTK)

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Session Details

Session Title: Interactive Free Paper Session: Femtosecond Small Lenticule Extraction I

Session Date/Time: Monday 07/09/2015 | 09:00-11:00

Paper Time: 10:42

Venue: Room 19

First Author: : J.Zhao CHINA

Co Author(s): :    L. Sun   M. Li   Y. Shen   M. Tian   X. Zhou        

Abstract Details


To investigate the feasibility, safety and effectivity of re-use of small incision lenticule extraction (SMILE) lenticule using epikeratophakia technique combined with phototherapeutic keratectomy (PTK).


Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.


This is a prospective pilot study. A 30-year-old woman and a 25-year-old man presented with decreased visual acuity due to recurrence of granular corneal dystrophy. PTK was performed using the Mel-80 excimer laser followed by the donor lenticules transplanted onto the recipient eyes(the left eye of woman and the right eye of man). SMILE procedures using the VisuMax femtosecond laser(Carl Zeiss Meditec AG)were performed on two myopic donors and the extracted lenticules were used as the epikeratophakia tissue. Postoperative treatments consisted of bandage soft contact lens, topical steroids, antibiotics, and artificial tears.


Surgery and postoperative follow-up were uneventful, and no complications were noted. The epithelium recovered within 18 hours and the transplanted lenticule survived. Three months postoperatively, the corrected distance visual acuity (CDVA) of woman's left eye gained two lines and the CDVA of man's right eye changed from counting fingers preoperatively to 20/25. Mean keratometric power increased by 5.0 diopters and 8.3 diopters, central corneal thickness increased by 35μm and 75μm, respectively. The epithelium healed and cornea remained clear over the follow-up period under slit-lamp examination. Anterior segment OCT observation showed the lenticule was transparent with its visible demarcation line.


The re-use of SMILE lenticule with epikeratophakia technique is safe, feasible, and effective. The predictability and long-term effects need to be further investigated.

Financial Interest:


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