Wedge technique for keratorefractive lenticule extraction

Keratorefractive lenticule extraction is the latest advancement in the field of refractive surgery. Difficulties in lenticule dissection with associated complications such as lenticule tear, incision cut extension, cap tear, or remanent lenticule fragments may have an increased incidence in the hands of a novice surgeon or with thinner lenticules. These complications can be avoided by optimizing machine energy parameters and ascertaining complete lenticule separation before attempted removal. We describe a technique for lenticule dissection to facilitate complete separation and smooth extraction. After complete anterior lamellar dissection, a small tissue wedge is left undissected during the posterior lenticule separation. This provides adequate counter resistance and allows lenticule fixation without undesired movements, during subsequent surgical maneuvers. The technique does not require an additional learning curve and is equally effective in the hands of a novice surgeon and in thin lenticules.