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

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.

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Risk Factors and Incidence of Suction Loss during Small Incision Lenticule Extraction (SMILE) in 8493 eyes

10.21203/rs.3.rs-55493/v2 ◽

2020 ◽

Author(s):

Tian-Ze Huang ◽

Ling Shen ◽

Xiao-Ning Yu ◽

Hong-Ying Jin

Keyword(s):

Risk Factors ◽

Eye Movements ◽

Significant Risk ◽

Male Gender ◽

Control Group ◽

Small Incision Lenticule Extraction ◽

Patient Anxiety ◽

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 8493 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 (74.2%) cases occurred in the right eye (the first operative eye) and 8 (25.8%) 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 0.25%. Head and eye movements during surgery caused suction loss in 16 (51.6%) and 15 (48.4%) 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: The risk factors of suction loss were first operative eye and male gender. Head and eye movements due to patient anxiety are the most common direct causes of suction loss. Surgeon’s experience may help to reduce the incidence of suction loss. Preoperative education and better communication during surgery needs to be emphasized.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 enrollment of the first participant to the trial: 1 January 2014.

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Risk factors and incidence of suction loss during small incision lenticule extraction (SMILE) in 8493 eyes

BMC Ophthalmology ◽

10.1186/s12886-020-01680-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Tian-Ze Huang ◽

Ling Shen ◽

Xiao-Ning Yu ◽

Hong-Ying Jin

Keyword(s):

Risk Factors ◽

Eye Movements ◽

Significant Risk ◽

Control Group ◽

Small Incision Lenticule Extraction ◽

Patient Anxiety ◽

Binary Logistic Regression Model ◽

Small Incision ◽

Lenticule Extraction ◽

Male Sex

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 8493 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 (74.2%) cases occurred in the right eye (the first operative eye) and 8 (25.8%) 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 0.25%. Head and eye movements during surgery caused suction loss in 16 (51.6%) and 15 (48.4%) eyes, respectively. Comparison between the suction loss group and the control group showed that the first operative eye and male sex are at a significantly high risk for suction loss (p < 0.05). Conclusions The risk factors of suction loss were first operative eye and male sex. Head and eye movements due to patient anxiety are the most common direct causes of suction loss. Surgeon’s experience may help to reduce the incidence of suction loss. Preoperative education and better communication during surgery needs to be emphasized. 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.

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Risk Factors and Incidence of Suction Loss during Small Incision Lenticule Extraction (SMILE) in 8493 eyes

10.21203/rs.3.rs-55493/v3 ◽

2020 ◽

Author(s):

Tian-Ze Huang ◽

Ling Shen ◽

Xiao-Ning Yu ◽

Hong-Ying Jin

Keyword(s):

Risk Factors ◽

Eye Movements ◽

Significant Risk ◽

Control Group ◽

Small Incision Lenticule Extraction ◽

Patient Anxiety ◽

Binary Logistic Regression Model ◽

Small Incision ◽

Lenticule Extraction ◽

Male Sex

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 8493 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 (74.2%) cases occurred in the right eye (the first operative eye) and 8 (25.8%) 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 0.25%. Head and eye movements during surgery caused suction loss in 16 (51.6%) and 15 (48.4%) eyes, respectively. Comparison between the suction loss group and the control group showed that the first operative eye and male sex are at a significantly high risk for suction loss (p < 0.05). Conclusions: The risk factors of suction loss were first operative eye and male sex. Head and eye movements due to patient anxiety are the most common direct causes of suction loss. Surgeon’s experience may help to reduce the incidence of suction loss. Preoperative education and better communication during surgery needs to be emphasized.

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Suction loss during femtosecond laser–assisted small-incision lenticule extraction: Incidence and analysis of risk factors

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2015.10.067 ◽

2016 ◽

Vol 42 (2) ◽

pp. 246-250 ◽

Cited By ~ 16

Author(s):

Ihab M. Osman ◽

Ramy Awad ◽

Wei Shi ◽

Mohamed Abou Shousha

Keyword(s):

Risk Factors ◽

Femtosecond Laser ◽

Small Incision Lenticule Extraction ◽

Small Incision ◽

Lenticule Extraction

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Two-year observation of posterior corneal elevations after small incision lenticule extraction (SMILE) for myopia higher than −10 dioptres

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313498 ◽

2019 ◽

Vol 104 (1) ◽

pp. 142-148 ◽

Cited By ~ 5

Author(s):

Xueyi Zhou ◽

Jianmin Shang ◽

Bing Qin ◽

Yu Zhao ◽

Xingtao Zhou

Keyword(s):

Central Area ◽

Control Group ◽

Small Incision Lenticule Extraction ◽

Small Incision ◽

Long Term Follow Up ◽

Lenticule Extraction ◽

Measured Change

AimTo investigate the change in posterior corneal elevations (PCEs) of eyes with extremely high myopia 2 years after small incision lenticule extraction (SMILE).MethodsWe evaluated 39 eyes of 39 patients with spherical equivalent higher than −10.00 dioptres (D). Using a Scheimpflug camera (Pentacam), we measured change in PCEs at 1 day, 3 months, 6 months and 2 years after SMILE. Another 34 eyes of 34 patients who underwent femtosecond laser-assisted in situ keratomileusis (FS-LASIK) were examined before, at 1 day and long-term after surgery as the control group. For each eye, elevations at central, thinnest, maximal points and 24 other predetermined points were measured.ResultsNo significant forward displacements of PCEs were observed in both surgeries. The maximal but not significant forward displacement occurred around 3–6 months following SMILE, and all returned to original levels 6 months postoperatively except superior area. The peripheral area tended to displace backward, while the central area tended forwardly. In both procedures, elevations along horizontal meridians, inferior and temporal hemispheres were significantly higher than those along vertical meridians, superior and nasal hemispheres, respectively (p<0.05). Elevation on the 4 mm, 6 mm diameters at 1 day and on the 6 mm diameter and temporal hemisphere at long-term follow-up postoperatively were significantly higher in FS-LASIK than SMILE (p<0.05). Change in elevations on the 6 mm diameter circle correlated with residual bed thickness (p=0.047).ConclusionsSMILE is a safe way to correct for myopia higher than −10 D, with PCEs remaining stable 2 years after surgery.

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