Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Intraoperative cap repositioning in small incision lenticule extraction (SMILE) for enhanced visual recovery

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Session Details

Session Title: Smile: Small Intrastromal Lenticule Extraction II

Session Date/Time: Tuesday 13/09/2016 | 16:00-17:30

Paper Time: 16:12

Venue: Hall C3

First Author: : R.Deshmukh INDIA

Co Author(s): :    R. Shroff   A. Agrawal   R. Shetty              

Abstract Details


To study the association between intra-operative cap repositioning and acute visual quality recovery after small incision lenticule extraction (SMILE).


Narayana Nethralaya, Bangalore


Sixty eyes of 30 patients underwent the SMILE procedure for correction of myopic refractive error. Manifest refraction and visual quality parameters (optical quality analysis system) were evaluated before surgery. The Bowman’s membrane was imaged using a handheld spectral domain ocular coherence tomography. All patients underwent uneventful SMILE surgery by a single experienced surgeon. Intra-operative cap repositioning was done in the ‘right’ eye of all patients (repositioned group) and the ‘left eyes’ served as controls (non-repositioned group). Visual acuity and optical quality was assessed one day and one week after surgery.


Bowman’s micro-distortions were found in 20% of eyes in the repositioned group and 60% of the eyes in the non-repositioned group (p=0.004) on first day after surgery. Comparison of optical quality parameters was carried out between eyes where repositioning was done and control eyes (with and without micro-distortions). On first day after surgery, the modulation transfer function (MTF) and Strehl’s ratio (SR) were significantly better in the repositioned eyes when compared to the controls (p=0.02 and p=0.01, respectively). Refractive error and lenticule thickness in eyes with micro-distortions was similar (p>0.05) between the two groups indicating other contributors to acute optical quality postoperatively.


Though the refractive error before surgery determines the extent of micro-distortions, intra-operative cap repositioning may reduce them and thereby expedite acute visual recovery after SMILE.

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