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Updated: Jan 26, 2026

Ye's Swing Technique for Small-incision Lenticule Extraction Surgery
Published on: June 27, 2025
Aborted small-incision lenticule extraction resulting from false plane creation and strategy for subsequent removal
Dan Z Reinstein1, Ryan S Vida2, Timothy J Archer2
1London Vision Clinic, London, United Kingdom; Biomedical Science Research Institute, Ulster University, Coleraine, United Kingdom; Columbia University Medical Center, New York, New York, USA; Sorbonne Université, Paris, France.
Abstract:
We describe a complication of false plane creation during small-incision lenticule extraction (SMILE) and the surgical plan for subsequent lenticule removal. During a primary SMILE procedure to treat high myopia, the separator instrument entered a false lamellar plane as a result of an area of resistance caused by an area of opaque bubble layer (OBL). The procedure was aborted to avoid removing an irregular lenticule. Based on measurements of the anatomic landscape, a new inferonasal small incision was created. The lenticule was separated and removed without further incidence. The patient recovered as normal and at 6 months, the uncorrected distance visual acuity was 20/16-1. This case highlights the importance of monitoring the bubble layer creation and interface separation to avoid creating or removing an irregular lenticule. It also shows the importance of layered corneal imaging to analyze and diagnose complications as well as of aborting a procedure and planning lenticule removal at a later time if deemed appropriate.
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