Relex Smile technology is an innovative method of laser correction of myopia and myopic astigmatism, minimally affecting the biomechanical properties of the cornea. This technique does not require cutting out a corneal flap and allows to remove the laser-formed corneal lenticule through a small incision. Ametropias, and especially high simple or complex myopic astigmatism, are the most frequent refractive complications after various types of keratoplasty (KP), which significantly reduce the visual acuity and the quality of life in patients, especially when refractive errors cannot be corrected by glasses or contact lenses due to their intolerance or due to anisometropia. Purpose. To evaluate the effectiveness of the residual ametropia correction with SMILE after anterior lamellar keratoplasty (ALK) in a patient with secondary keratectasia. Material and methods. A patient, 30, with complaints of low vision in the left eye. The patient has been noticing a decrease in vision since the age of 18, suffers from myopia. Anamnesis: photorefractive keratectomy and accelerated corneal crosslinking in both eyes. ALK was performed in the left eye. The patient underwent microinvasive femtolaser-assisted extraction of the corneal lenticula using the Relex Smile technique. UCVA and autorefraction data were evaluated 1 week, 1 month and 3 months after surgery. Results. On the first day after the Relex Smile procedure, uncorrected visual acuity (UCVA) was 0.3. 3 months after the operation, UCVA was 0.9 in the left eye. The postoperative spherical equivalent and visual acuity were stable during the 12-month dynamic follow-up, UCVA was 0.9, refractive indices sph –0.5D cyl –0.75D ax 82°, residual corneal thickness 580 microns. Conclusion. Intrastromal extraction of corneal lenticula — Relex Smile -is an alternative, effective, safe and stable technique of induced ametropia correction after deep anterior lamellar keratoplasty. Keywords: Relex Smile, anterior lamellar keratoplasty, induced ametropia, keratectasia