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The challenges in the learning curve of small-incision lenticule extraction in a Bangladeshi population

Poster Details

First Author: H.Rashid BANGLADESH

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Abstract Details


The aim of the study is to analyze the early learning curve in terms of intraoperative complications and postoperative refractive outcome following Small Incision Lenticule Extraction in Bangladeshi population.


All the small incision lenticle extractions were performed with VisuMax femtosecond laser at Lasik sight Center, Dhaka, Bangladesh by a single surgeon.


A prospective study has been done on 100 eyes from 50 patients scheduled for small lenticule extraction by a single surgeon for the first time in Bangladeshi population. The selective criteria for the patients were: the age of the patients ranged from 18yrs to 37yrs and the range of the refractive error was -1.0D to -10.0D. Small incision lenticular extraction has been done by means of 500 kHz VisuMax femtosecond laser by Carl Zeiss Meditec. Intraoperative complications have been noted. Postoperative visual acuity was measured and recorded on day 7, day 30 and day 60.


Different kinds of intraoperative complications occured during learning phases of small lenticule extraction. like suction loss, incision tear, retained lenticule, cap lenticular  adhesion etc. All these complications influence the visual outcome after surgery. The study reveals, Mean postoperative UDVA and CDVA were 0.19 ± 0.17 and 0.05 ± 0.07 logMAR respectively. At day 60, 77% of the eyes were within ±0.50 D and and 96%  of the  eyes were within ±1.00 D of the intended correction.


The study concludes that, although SMILE is a promising and most advanced procedure in terms of visual outcome , it is surgically challenging. Lenticule dissection and extraction are the most difficult steps that need experience to do it properly with minimal complications. Intraoperative complications cause delay in visual recovery in initial cases of a surgeon.

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