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Re-treatment for incomplete SMILE due to suction loss can be predictable, safe
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Re-treatment with a femtosecond laser after suction loss in eyes during small incision lenticule extraction did not affect accuracy, predictability or safety, according to a study. In addition, patients did not notice a difference in vision.
Researchers included 8,490 eyes of 4,296 patients in a prospective, paired-eye case study at Zhongshan Ophthalmic Center, China. Thirty-five eyes in the cohort experienced suction loss during SMILE for treatment of myopia or myopic astigmatism. These eyes were re-treated with SMILE, femtosecond laser-assisted LASIK or a pseudo-SMILE procedure. Fellow eyes were then treated with SMILE.
Corrected distance visual acuity, uncorrected distance visual acuity, morphic modification of corneal architecture, manifest refraction and higher-order aberrations were evaluated at 1 day, 1 week, 1 month and 3 months postoperatively.
Eyes that experienced suction loss had significantly worse high-contrast corrected distance visual acuity at 1 week postoperatively compared with contralateral eyes, but the difference was not significant at 1 month and 3 months postoperatively. Additionally, there was no statistically significant difference between suction loss eyes and contralateral eyes for the overall safety index and efficacy index at 1 month and 3 months postoperatively.
“In this series, 51% of suction losses occurred during the cap cut. After cleaning the opaque bubble layer pattern, the femtosecond laser was activated again and the SMILE re-treatment was performed. We found that the accuracy and predictability of cap thickness after double femtosecond laser pass for an incomplete SMILE cap did not differ from the single pass in the fellow eyes,” the study authors wrote.
Disclosure: The authors report no relevant financial disclosures.
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