Lenticuloschisis: A “No Dissection” Technique for Lenticule Extraction in Small Incision Lenticule Extraction

Abstract

PURPOSE: To describe a “no dissection” technique of lenticule removal in small incision lenticule extraction (SMILE). METHODS: After docking and laser delivery, a microforceps is used to grasp and gently peel off the lenticule from the underlying stromal bed, without performing any dissection of the upper and lower planes of the lenticule. Prerequisites are a surgeon experienced in the conventional SMILE technique, optimized laser energy settings, and a minimum peripheral lenticule thickness of 25 to 30 µ m. RESULTS: The interface as assessed in postoperative dilated clinical photographs was seen to be clearer with less roughness compared to the conventional dissection technique. This may potentially result in better first postoperative visual acuity and quality of vision due to less corneal tissue trauma and minimal tissue handling, thus potentially resulting in faster visual recovery. CONCLUSIONS: No dissection lenticule removal is a feasible and reproducible technique that may result in better immediate visual quality compared to the conventional SMILE technique. [ J Refract Surg. 2017;33(8):563–566.]