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Refraction outcomes after suction loss during small-incision lenticule extraction (SMILE)

Authors Gab-Alla AA

Received 25 January 2017

Accepted for publication 17 February 2017

Published 13 March 2017 Volume 2017:11 Pages 511—515

DOI https://doi.org/10.2147/OPTH.S133188

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Amr A Gab-Alla

Ophthalmology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Purpose: To evaluate refractive outcomes of two management approaches after suction loss during the small-incision lenticule extraction (SMILE) technique.
Patients and methods: This retrospective and comparative study was conducted at the El-Gowhara Private Eye Center. It included 26 consecutive eyes of patients who experienced suction loss during the SMILE technique. Patients were divided into two groups by the technical difficulties in redocking: in group A (12 eyes) suction loss occurred after the posterior lenticular cut and the creation of side-cuts, then suction was reapplied, and the procedure was completed; in group B (14 eyes) suction loss occurred after the posterior lenticular cut and the creation of side-cuts, then the procedure was postponed for 24 hours and completed with the same parameters. Manifest refraction outcomes were measured and compared 6 months postoperatively.
Results: This study included 26 eyes with suction loss during the SMILE technique: five patients with suction loss in both eyes, nine patients with suction loss in the right eye and seven patients with suction loss in the left eye. The incidence of suction loss in this study was 2.7%. At the postoperative 6-month follow-up time, there were statistically significant differences in refraction outcomes between the two groups, with a hyperopic shift in group A compared with group B.
Conclusion: A good refraction outcome can be achieved with appropriate management of suction loss during the SMILE technique, and it is recommended to postpone the treatment if this happens.

Keywords: diffuse lamellar keratitis, LASIK, interface fluid syndrome, myopia

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