Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (6): 20-24.doi: 10.6040/j.issn.1673-3770.0.2021.008

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Active suction loss to treat complications of small-incision lenticule extraction

CHEN Tao1, LI Yaoyu1, YANG Majun1, YAN Hongxin1, LIU Guangyi1, ZHAI Changbin2   

  1. 1. Beijing Feng Lian Jia Yue Li Ge Eye Clinic, Beijing100020, China;
    2. Beijing Tongren Eye center, Beijing Tongren Hospital Capital Mediceal University / Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
  • Published:2021-12-10

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Abstract: Objective To guide the treatment of complications, such as suction loss or potential suction loss, during small-incision lenticule extraction(SMILE). Methods Causes and treatment methods of suction loss or potential suction loss during SMILE were retrospectively analyzed at our hospital from January 2018 to April 2019. Twenty-two eyes experienced passive suction loss; five eyes experienced suction loss when the Laser microlens bottom scanning exceeded <10%, necessitating re-scanning; two eyes experienced suction loss when the Laser microlens bottom scanning exceeded >10%, necessitating the termination of SMILE and treatment with femtosecond laser-assisted laser in situkeratomileusis; two eyes experienced suction loss during lens circumcision; nine eyes experienced suction loss during cap scanning; and four eyes experienced suction loss during scanning incision, when the repair program was started to adjust parameters to scan corneal cap again. Active suction loss occurred in seven eyes, including two eyes with a scanning black area, four eyes with poor coordination, and one eye with active suction in the secondary SMILE remediation surgery. Results Patients with active suction loss recovered well owing to treatments of the black spot during scanning; patients with potential suction loss were treated with active suction loss and re-scanned after their mood relaxed, and their recovery was good. Conclusion Preoperative fixation training, education, and stabilization of patients' tension could effectively reduce passive suction loss. Before negative pressure suction, excess water on the ocular surface should be removed, and cleaning the eye surface can effectively prevent passive suction loss. Passive suction loss can be prevented in femtosecond surgery, and active suction loss can be effectively used to deal with complications of the whole femtosecond laser scanning process to ensure good postoperative effects.

Key words: Femtosecond laser small incision lenticule extraction, Active suction loss, Passive suction loss, Femtosecond laser-assisted laser in situkeratomileusis

CLC Number: 

  • R778
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