Para Incisional Quadrant Saving Dissection in Refractive Lenticule Extraction for Myopia by Reverse Pull using Shearing Applied Force Extraction (SAFE)

Abstract

There is no standard technique of lenticule separation in Refractive Lenticule Extraction (ReLEx) or Small Incision Lenticule Extraction (SMILE) procedure used for spectacle number treatment by Laser. We present a unique method of lenticule dissection using reverse pull by shearing applied force extraction (SAFE) to ensure complete removal of the lenticule with minimal postoperative inflammation. This technique keeps the lenticule under control of the operating surgeon throughout the dissection. Random separation of lenticule may leave a part of the lenticule attached to the periphery. Separated lenticule overrides the attached part of lenticule. This reduced visibility of the attached part makes further separation difficult and causes excessive manipulation, consumes more time, leads to inflammation and may cause incomplete lenticule removal. This new technique ensures safe and full removal of the lenticule irrespective of its thickness (thin lenticule is difficult to identify and separate while thick lenticule tends to get accumulated on one side) and improves postoperative outcome.