Difficult Small-Incision Lenticule Extraction

ReLEx SMILE technique involves creation of a refractive lenticule with a femtosecond LASER which is extracted through a 3mm incision. The lenticule in order to be removed must be free of its surrounding adhesions. Anterior surface of the lenticule is first separated and then the posterior layer. Inadvertent separation of the posterior layer first causes the lenticule to be struck on the underside of the cap. A technique to separate the lenticule in such a situation is demonstrated.