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Updated: Jul 30, 2025

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
Femto-SMILE after photo-therapeutic keratectomy in an eye with failed LASIK flap: A case report
Ramy Awad1, Khaled Awad1, Ahmed Bakry1
1Alexandria General Ophthalmology Hospital, Alexandria, Egypt.
Purpose:
The aim of the study is to describe a case where Femtosecond Intrastromal Lenticule Extraction was used to address the refractive defect following topography-guided phototherapeutic keratectomy (topo-PTK) to regularise a scarred corneal surface after an initial LASIK flap formation attempt failed.
Observations:
A 23-year-old female experienced a thin and irregular corneal flap, during a microkeratome LASIK surgery of the right eye. Subsequently, she experienced epithelial ingrowth. Three months postoperatively the cornea showed scarring and partial flap melting. Topo-PTK was employed to ablate the scarred surface rendering it regular. Treatment with Femtosecond Intrastromal Lenticule Extraction was performed to correct the final refractive error of Sph -5.50 Cyl -2.00 Axis 180° with a happy end of uncorrected visual acuity (UCVA) of 20/20.
Conclusions And Importance:
Femtosecond Intrastromal Lenticule Extraction can be used for retreatment after surface ablation. Topo-PTK can be used to ablate post-operative LASIK-induced irregularities with a successful outcome.

