Ophthalmologist Dean Corbett, of Auckland, NZ was the worthy winner of the annual AUSCRS Film Festival Trophy. He profiled a case – with a video of IOL surgery and a music soundtrack – while presenting a live voiceover.

Dean had ordered custom made 45D IOLs for a 17.8mm axial length eye with high hyperopia. The first IOL was a doddle however, during the second procedure, the posterior capsule was damaged. The highest power sulcus IOL available was 32D. This left the patient 10D hyperopic, under-corrected. After considering all options, he decided to piggyback an ICL onto the IOL, which he did with an excellent outcome. 

His case is believed to be the first documented use of an ICL as a resolution for this type of problem.  Despite over a million SMILE procedures having been performed worldwide, this technique received relatively little attention at AUSCRS.  

Seemingly, those who practice SMILE surgery swear by it, but those who don’t are understandably not as enthusiastic. Ie asked Dean for his take on SMILE and he said, “The United States Food and Drug Administration recently opened the door for SMILE astigmatism correction. 

As a result, worldwide numbers will grow at an unprecedented rate, as people look for a less invasive surgical technique for focus correction.

“Data was presented showing equivalence of outcomes for low myopes as compared to LASIK. This area has been hotly debated, and numbers in the published literature were very modest. While there is still an accepted understanding that SMILE patients' visual recovery may be slightly slower than their LASIK counterparts, it seems that as the technology is becoming more mature and the learning curve of surgeons is becoming less steep, these differences may become less dramatic,” he said.

“While LASIK, as a means for correcting vision has plateaued, and perhaps even trended downwards, there is little doubt that SMILE has rejuvenated excitement amongst surgeons and patients alike.

“We look forward to an increasing body of evidence supporting this  promising technique.”

Article reproduced from 14 December 2018 edition of mivision.