Using lenticule anatomy, mentally preparing patients key for successful SMILE procedures
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CHICAGO — Surgeons should use lenticule anatomy to their benefit to choose certain parameters and conduct successful SMILE procedures, according to a speaker here.
“When you review the literature on SMILE, you will notice a focus on three main areas: visual outcomes, corneal nerves and biomechanics,” Saama Sabeti, MD, MPH, FRCSC, said at Refractive Surgery Subspecialty Day at the American Academy of Ophthalmology meeting.
Sabeti said that it is important to not forget about cylinder and centration when performing SMILE and to mentally prepare each patient for the procedure. Additionally, surgeons should pay attention to their planes and respect their incisions.
To avoid complications during lenticule dissection, it can be useful to start with a larger incision during early cases, Sabeti said. Surgeons can also use the incision as a fulcrum for spatula movement.
To avoid suction loss during laser delivery, it is best to prevent the issue from occurring in the first place, she said. Risk factors for suction loss include patient eye and head movement, Bell’s phenomenon, attempts by the patient to fixate, tears in the conjunctival fornix, narrow lid fissure, large cap diameter, higher amounts of cylinder and surgeon inexperience.
Taking a course can also be useful for SMILE, Sabeti said.
“A refresher is always a good idea as well,” she said. “We are constantly learning, and I think that this is an exciting procedure.”
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Sabeti S. SMILE ... I’m ready now! My top 5 pearls for the beginner SMILE surgeon. Presented at: American Academy of Ophthalmology meeting; Sept. 30 – Oct. 3, 2022; Chicago.
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