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Correction of refractive surprise after cataract surgery using small incision lenticule extraction (SMILE) technique

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Session Details

Session Title: Femtosecond Small Lenticule Extraction II

Session Date/Time: Tuesday 08/09/2015 | 16:30-18:30

Paper Time: 18:20

Venue: Room 17

First Author: : A.Elsayed EGYPT

Co Author(s): :    A. Elnady   A. Ahmed                 

Abstract Details


Evaluation of SMILE technique in correcting post cataract surgery refractive surprises due to IOL miscalculation.


Alpha Vision eye center, Zagazig, Egypt.


Twenty eyes of 17 patients who had had previous cataract surgery 3 to 48 months ago and had significant myopia and/or myopic astigmatism but aim to be glasses independent were enrolled in this study. Pentacam was performed to check if their corneal thickness and topography permit corneal refractive correction. The selected subjects underwent small incision lenticule extraction using Zeiss Vsumax 500 femtolaser platform (Jena, Germany) to correct their refractive error.


Preoperative refraction ranged from -3 to -8 D sphere and -1 to -4D cylinder. Three months after SMILE, 90% of eyes were within ± 1.0 D. One eye (5%) lost two lines of preoperative BSCVA in the first month. Intraoperative complications included; suction loss in 2 cases (10%), radial tear at the access incision in one case (5%) difficult dissection in one case (5%) but no cases of cataract wound dehiscence. Visual recovery was delayed in 2 eyes (10%) one of them had interface haze that cleared by the third month.


SMILE technique proved to be safe and effective in correction refractive surprise post cataract surgery. SMILE avoids IOL exchange which might be difficult long time after surgery, carries the risk of infection and may induce more surgically induced astigmatism. SMILE allows full correction of both myopia and astigmatism even earlier than LASIK due to less IOP rise during the procedure.

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