A New Paradigm for Refractive Surgery: SMILE-Small Incision Lenticule Extraction
Automated lamellar keratoplasty (ALK) was a technique to physically remove a refractive lenticule (the lenticule was merely a disc of corneal tissue) from the cornea after lifting a hinged flap and exposing the stroma. A mechanical microkeratome was used to do both steps of the ALK procedure. In the LASIK procedure, the refractive lenticule was ablated with the excimer laser, while the hinged flap was still created with the mechanical microkeratome. In a later iteration, Femto-LASIK involved creation of the hinged flap with a femtosecond laser, and an excimer laser was used to ablate the refractive lenticule. SMILE, a relatively new technique of performing refractive surgery, uses a femtosecond laser for all steps of the keratomileusis procedure. SMILE involves the creation of a refractive lenticule within the cornea using a femtosecond laser, and subsequent extraction of the refractive lenticule from within the cornea. The refractive error that needs to be treated defines the shape of

