MINI-SMILE FOR CHALLANGING CASES

To use the ReLEx SMILE method with less than 2 mm incision and extract a lenticule throw it (1 mm long on average).

To evaluate the possibility and safety of this procedure and assess the comfort for the surgeon.

A single-surgeon, consecutive case-series study.

“Doctor’s Shilova clinic” Moscow, Russia

A standard technology does not allow programming an access to the lenticule less than 2 mm.

Only in a case with partial formation of the entrance with size 1 mm or even less we can study the possibility of separation and extraction lenticule through it. The study included 5 cases. We performed a full-fledged SMILE procedure in all cases using a special technique for isolating the upper and lower surfaces of the lenticula. SEQ was - 5.75 ± 3.5 D, lenticular thickness of 52-160 microns. Laser cuts were performed in expert mode with an energy of 125-130 NJ.

In these cases, we have a little size less than 2 mm for procedure SMILE. When determining the surfaces of the lenticula, a clear visualization of both the upper and lower planes was required, which was achieved by the opposite direction of movement of the spatula with its rotation in the found planes. In all cases, all stages of operations were completed, and lenticular extraction was performed in full. The refractive result corresponded to the planned one.

In selected patients with a small inlet, we perform mini-SMILE through 1.0mm at average. So, we can advise to use only one input while minimizing its size and consider reducing the incision when programming the procedure by making a 1 mm input available. This will be a good option for SMILE as less invasive surgical procedure which provides fast restoration of high visual acuity, to minimize nerve plexus injury and speedy healing.