EyeWorld Asia-Pacific September 2019 Issue

Finally, the inferior one-third of the flap can be separated (Figure 3D). It is also important to apply some upward pressure as the tip is passed across to avoid the tip breaking through to the original SMILE interface. In the first 4,000 SMILE proce- dures performed at London Vision interfaces. The best technique is to enter mid-flap (Figure 3A) and push across the diameter of the flap (Figure 3B). Once a new access point is created, the second instrument can enter and be used to separate the superior two-thirds of the flap while the other instrument is held in place as an anchor (Figure 3C). Clinic, London, UK, by Dr. Carp and Prof. Dan Reinstein, 2.5% required a retreatment. All retreatments were performed by thin-flap LASIK. An M ring was used in 93% of eyes to make sure there was enough clearance from the small incisions. Finally, Dr. Carp said that almost all of the intraoperative complications occurred prior to development of this technique. The complications were due to inadvertently accessing the original interface at the superior portion of the flap. Once the new flap-lift technique was perfected, Sponsored by Carl Zeiss Meditec Sponsored by Carl Zeiss Meditec Figure 3. Pearls to a thin LASIK flap Source: Glenn Carp, MBBCh, FC Ophth (SA)