Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives

Jeewan S Titiyal, Manpreet Kaur, Farin Shaikh, Meghal Gagrani, Anand Singh Brar, Anubha Rathi Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India Abstract: Refractive lenticule extraction is...

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Autores principales:	Titiyal JS, Kaur M, Shaikh F, Gagrani M, Brar AS, Rathi A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	small incision lenticule extraction SMILE refractive lenticule extraction Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/436f5e843e69466dbfc274b93e4bd581
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spelling	oai:doaj.org-article:436f5e843e69466dbfc274b93e4bd5812021-12-02T05:27:16ZSmall incision lenticule extraction (SMILE) techniques: patient selection and perspectives1177-5483https://doaj.org/article/436f5e843e69466dbfc274b93e4bd5812018-09-01T00:00:00Zhttps://www.dovepress.com/small-incision-lenticule-extraction-smile-techniques-patient-selection-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jeewan S Titiyal, Manpreet Kaur, Farin Shaikh, Meghal Gagrani, Anand Singh Brar, Anubha Rathi Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India Abstract: Refractive lenticule extraction is becoming the procedure of choice for the management of myopia and myopic astigmatism owing to its precision, biomechanical stability, and better ocular surface. It has similar safety, efficacy, and predictability as femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and is associated with better patient satisfaction. The conventional technique of small incision lenticule extraction (SMILE) involves docking, femtosecond laser application, lenticule dissection from the surrounding stroma, and extraction. It has a steep learning curve compared to conventional flap-based corneal ablative procedures, and the surgical technique may be challenging especially for a novice surgeon. As SMILE is gaining worldwide acceptance among refractive surgeons, different modifications of the surgical technique have been described to ease the process of lenticule extraction and minimize complications. Good patient selection is essential to ensure optimal patient satisfaction, and novice surgeons should avoid cases with low myopia (thin refractive lenticules), difficult orbital anatomy, high astigmatism, or uncooperative, anxious patients to minimize complications. A comprehensive MEDLINE search was performed using “small incision lenticule extraction,” “SMILE,” and “refractive lenticule extraction” as keywords, and we herein review the patient selection for SMILE and various surgical techniques of SMILE with their pros and cons. With increasing surgeon experience, a standard technique is expected to evolve that may be performed in all types of cases with optimal outcomes and minimal adverse effects. Keywords: refractive lenticule extraction, femtosecond-laser assisted lenticule extraction, SMILE techniques, refractive surgeryTitiyal JSKaur MShaikh FGagrani MBrar ASRathi ADove Medical Pressarticlesmall incision lenticule extractionSMILErefractive lenticule extractionOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1685-1699 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	small incision lenticule extraction SMILE refractive lenticule extraction Ophthalmology RE1-994
spellingShingle	small incision lenticule extraction SMILE refractive lenticule extraction Ophthalmology RE1-994 Titiyal JS Kaur M Shaikh F Gagrani M Brar AS Rathi A Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
description	Jeewan S Titiyal, Manpreet Kaur, Farin Shaikh, Meghal Gagrani, Anand Singh Brar, Anubha Rathi Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India Abstract: Refractive lenticule extraction is becoming the procedure of choice for the management of myopia and myopic astigmatism owing to its precision, biomechanical stability, and better ocular surface. It has similar safety, efficacy, and predictability as femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and is associated with better patient satisfaction. The conventional technique of small incision lenticule extraction (SMILE) involves docking, femtosecond laser application, lenticule dissection from the surrounding stroma, and extraction. It has a steep learning curve compared to conventional flap-based corneal ablative procedures, and the surgical technique may be challenging especially for a novice surgeon. As SMILE is gaining worldwide acceptance among refractive surgeons, different modifications of the surgical technique have been described to ease the process of lenticule extraction and minimize complications. Good patient selection is essential to ensure optimal patient satisfaction, and novice surgeons should avoid cases with low myopia (thin refractive lenticules), difficult orbital anatomy, high astigmatism, or uncooperative, anxious patients to minimize complications. A comprehensive MEDLINE search was performed using “small incision lenticule extraction,” “SMILE,” and “refractive lenticule extraction” as keywords, and we herein review the patient selection for SMILE and various surgical techniques of SMILE with their pros and cons. With increasing surgeon experience, a standard technique is expected to evolve that may be performed in all types of cases with optimal outcomes and minimal adverse effects. Keywords: refractive lenticule extraction, femtosecond-laser assisted lenticule extraction, SMILE techniques, refractive surgery
format	article
author	Titiyal JS Kaur M Shaikh F Gagrani M Brar AS Rathi A
author_facet	Titiyal JS Kaur M Shaikh F Gagrani M Brar AS Rathi A
author_sort	Titiyal JS
title	Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
title_short	Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
title_full	Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
title_fullStr	Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
title_full_unstemmed	Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives
title_sort	small incision lenticule extraction (smile) techniques: patient selection and perspectives
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/436f5e843e69466dbfc274b93e4bd581
work_keys_str_mv	AT titiyaljs smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives AT kaurm smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives AT shaikhf smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives AT gagranim smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives AT braras smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives AT rathia smallincisionlenticuleextractionsmiletechniquespatientselectionandperspectives
_version_	1718400406048997376

Small incision lenticule extraction (SMILE) techniques: patient selection and perspectives

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