Abstract

A 23-year-old female with a subjective refraction of -4DS/-2.5DC @10 deg in right eye and -4.5DS/-1DC @170 deg in the left eye and BCVA of 6/6 in both eyes underwent SMILE with VISUMAX 800 (Carl Zeiss Meditec AG). It was noted during firing of the laser that no air bubble pattern was created. However, the side cut and the insicion were visible, indicative of completion of the laser. Lenticular dissection and removal was carried out without any complications. Lenticules were sent histopathology. UCVA on post operative day 1,15 and 3 months in both eyes was 6/6. The objective scatter index on post operative day1 was 2.1 and 1.1 and on day 15 was 0.4 and 0.6 in the right and left eyes respectively. On histopathology, there was a remarkable difference in the arrangement of collagen fibrils in the form of a haphazard orientation as seen on polarised light, which is not seen in other normal corneal lenticules and may explain the lack of an air bubble pattern in this case.