The First Step: A Young Ophthalmologist’S Journey Into Smile & Postoperative Surprises

Transitioning from residency to independent surgical practice is a challenging yet pivotal phase for young ophthalmologists. This presentation aims to provide an early-career perspective on performing Small Incision Lenticule Extraction (SMILE) as a first-time refractive surgeon, highlighting both intraoperative lessons and unexpected postoperative findings.

The surgeries were performed at a private ophthalmology clinic in Armenia, equipped with a VisuMax femtosecond laser system (Carl Zeiss Meditec). 

As the first ophthalmologist to perform SMILE in Armenia, I document my experience from surgical training to real-world patient management. I will discuss key learning curves, initial case outcomes, and an overlooked yet crucial aspect—early postoperative corneal appearance. Using clinical images and case examples, I explore how immediate post-op eyes can deviate from textbook expectations and how young surgeons can differentiate normal healing variations from true complications.

While SMILE is known for its minimally invasive nature, early postoperative findings can sometimes be alarming to both surgeons and patients. Observations from my initial cases include mild interface irregularities and epithelial responses, which resolved without intervention. These findings underscore the importance of setting realistic expectations, patient reassurance, and thorough postoperative monitoring.

Introducing a new surgical technique as a young ophthalmologist presents unique challenges but also invaluable learning opportunities. By sharing my journey, I hope to provide practical insights for early-career refractive surgeons, encourage confidence in tackling refractive surgery, and emphasize the need for a nuanced approach to postoperative assessments.