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Related Concept Videos

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Related Experiment Video

Updated: Jan 6, 2026

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Refractive surprise: twice the SMILE.

Garvit Bhutani1,2, Somasheila I Murthy1,2, Jagadesh C Reddy1,2

  • 1Tej Kohli Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India.

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A retained lenticule after small incision lenticule extraction (SMILE) surgery caused decreased vision. Converting the retained lenticule to a flap successfully restored the patient's vision and refractive error.

Keywords:
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Area of Science:

  • Ophthalmology
  • Refractive Surgery

Background:

  • Small incision lenticule extraction (SMILE) is a popular refractive surgery procedure.
  • Complications, though rare, can occur and require prompt management.

Observation:

  • A 35-year-old male patient experienced decreased vision in his left eye post-SMILE surgery.
  • The post-operative refractive error was significantly higher than his pre-operative error.

Findings:

  • The patient was diagnosed with a retained lenticule, folded onto itself.
  • Surgical conversion to a femtosecond laser-assisted in situ keratomileusis (LASIK) flap successfully resolved the issue.

Implications:

  • This case highlights a rare complication of SMILE surgery.
  • Management by conversion to a LASIK flap can effectively restore visual acuity and refractive outcomes.