Development of a liquid dissection technique for small-incision lenticule extraction: Clinical results and ultrastructural evaluation

2018 ◽  
Vol 44 (9) ◽  
pp. 1080-1089 ◽  
Author(s):  
Shengbei Weng ◽  
Xiaonan Yang ◽  
Fang Liu ◽  
Haiqin Lin ◽  
Manli Liu ◽  
...  
Keyword(s):  
Clinical Results ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Dissection Technique

scholarly journals Risk Factors and Incidence of Suction Loss during Small Incision Lenticule Extraction (SMILE) in 8487 eyes

2020 ◽  
Author(s):  
Tian-Ze Huang ◽  
Ling Shen ◽  
Xiao-Ning Yu ◽  
Hong-Ying Jin
Keyword(s):  
Risk Factors ◽  
Eye Movements ◽  
Significant Risk ◽  
Clinical Results ◽  
Male Gender ◽  
Control Group ◽  
Small Incision Lenticule Extraction ◽  
Binary Logistic Regression Model ◽  
Small Incision ◽  
Lenticule Extraction

Abstract Background: To report the incidence and risk factors of suction loss during small incision lenticule extraction (SMILE).Methods: This retrospective comparative case control study included 8487 eyes of 4261 patients. Patients underwent SMILE surgery between January 2014 and September 2019 were included. Videos of suction loss were reviewed, and the direct causes of suction loss were noted. An independent samples t-test was used for comparisons between the suction loss group and the control group. A binary logistic regression model was used to determine the possible significant risk factors that might increase the likelihood of suction loss during SMILE surgery.Results: Suction loss occurred in 31 (0.37%) eyes of 30 patients; 23 (74%) cases occurred in the right eye (the first operative eye) and 8 (26%) cases occurred in the left eye. Among the 30 patients, 23 (76.7%) were male and 7 (23.3%) were female. The incidence in the six consecutive years were 0%, 2.13%, 0.34%, 0.24%, 0.22%, and 0.23%. Head and eye movements during surgery caused suction loss in 15 (48.4%) and 16 (51.6%) eyes, respectively. Comparison between the suction loss group and the control group showed that the first operative eye and male gender are at a significantly high risk for suction loss (p < 0.05).Conclusions: Surgical experience may influence the incidence of suction loss during SMILE surgery. The two events that easily led to suction loss were head and eye movements. The risk factors were first operative eye and male gender.Trial registration: Retrospectively registered. ChiCTR-ORC-17011040. Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 1 January 2014.

scholarly journals SMILE and Wavefront-Guided LASIK Out-Compete Other Refractive Surgeries in Ameliorating the Induction of High-Order Aberrations in Anterior Corneal Surface

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Min-jie Ye ◽  
Cai-yuan Liu ◽  
Rong-feng Liao ◽  
Zheng-yu Gu ◽  
Bing-ying Zhao ◽  
...  
Keyword(s):  
Spherical Aberration ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Corneal Surface ◽  
Small Incision ◽  
Significant Difference ◽  
Lenticule Extraction ◽  
A Prospective Study ◽  
High Order Aberrations

Purpose. To compare the change of anterior corneal higher-order aberrations (HOAs) after laser in situ keratomileusis (LASIK), wavefront-guided LASIK with iris registration (WF-LASIK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), and small incision lenticule extraction (SMILE).Methods. In a prospective study, 82 eyes underwent LASIK, 119 eyes underwent WF-LASIK, 88 eyes underwent FS-LASIK, and 170 eyes underwent SMILE surgery. HOAs were measured with Pentacam device preoperatively and 6 months after surgery. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs, spherical aberration (SA), horizontal coma, and vertical coma over 6 mm diameter central corneal zone.Results. Six months postoperatively, all procedures result in increase of anterior corneal total HOAs and SA. There were no significant differences in the induced HOAs between LASIK and FS-LASIK, while SMILE induced fewer total HOAs and SA compared with LASIK and FS-LASIK. Similarly, WF-LASIK also induced less total HOAs than LASIK and FS-LASIK, but only fewer SA than FS-LASIK (P<0.05). No significant difference could be detected in the induced total HOAs and SA between SMILE and WF-LASIK, whereas SMILE induced more horizontal coma and vertical coma compared with WF-LASIK (P<0.05).Conclusion. FS-LASIK and LASIK induced comparable anterior corneal HOAs. Compared to LASIK and FS-LASIK, both SMILE and WF-LASIK showed advantages in inducing less total HOAs. In addition, SMILE also possesses better ability to reduce the induction of SA in comparison with LASIK and FS-LASIK. However, SMILE induced more horizontal coma and vertical coma compared with WF-LASIK, indicating that the centration of SMILE procedure is probably less precise than WF-LASIK.

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