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This video displays cap-lenticular adhesion with retained lenticule and Sinskey method to manage cap-lenticular adhesions. Lenticule misdissection and cap-lenticular adhesions most frequently encountered difficult situation in the learning curve of SMILE. Increased tissue handling and decreased total surgical time: delayed visual recovery, suboptimal visual quality: modulation transfer function and Strehl ratio, irregular interface with haze may persist, suboptimal visual outcomes in cases with co-existent complications such as cap tears or partially retained lenticule fragments. Management of lenticule mis-dissection and cap-lenticular adhesion: ASOCT to identify dissection planes and diagnose cap-lenticular adhesions, Sinskey hook assisted peeling of lenticule from overlying cap, inability to identify dissection planes avoid forceful dissection and retreat at later date.
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