Management of Complications in SMILE

Although small-incision lenticule extraction (SMILE) is safe overall, certain complications unique to SMILE can be encountered. This video illustrates complications encountered intraoperatively, including cap-lenticular adhesion, lenticular rupture, and retained partial lenticular fragment; and those seen postoperatively, including epithelial ingrowth, haze, and interface inflammation. We describe the stepwise management of these complications. Approaches to try to minimize these complications, including the importance of identifying the correct lenticular plane and the different approaches to lenticular dissection, are described. Approaches to dissecting the epithelial ingrowth postoperatively and management of the interface are illustrated.