Incidence of complications of SMall Incision Lenticule Extraction (SMILE)
Samuel J. Avalos-Lara, Cristina Pacheco-Del Valle
Keywords :
Refractive surgery, Small incision lenticule extraction, Complications
Citation Information :
Avalos-Lara SJ, Pacheco-Del Valle C. Incidence of complications of SMall Incision Lenticule Extraction (SMILE). 2020; 94 (2E):71-76.
Purpose: To summarize the complications and their incidence in the learning curve of the “small incision lenticule extraction (SMILE)” surgical technique. Material and methods: Prospective, descriptive and observational study. We evaluated the intraoperative and postoperative complications of patients undergoing SMILE refractive surgery with femtosecond laser from January 2015 to January 2018 at the Hospital Nuestra Señora de la Luz, Mexico. The platform used for surgery was the VisuMax by Zeiss. Statistical analysis was performed with Excel. Results: 526 eyes of 263 patients undergoing “SMILE” refractive surgery were studied. Intraoperative complications were observed in 70 of 526 eyes. The main complication was difficult lenticule extraction in 27 eyes (5.13%), epithelial abrasion in 15 eyes (2.85%), incision tear 12 in eyes (2.28%), lost vacuum in 7 eyes (1.33%), incomplete lenticule removal in 4 eyes (0.76%), black spot in 4 eyes (0.76%) and wound bleeding in 1 eye (0.19%). All complications were resolved intraoperatively. Conclusions: SMILE surgical technique is safe, showing excellent results in final visual acuity
Mysore N, Krueger R. Advances in Refractive Surgery May 2013 to June
Asia Pac J Ophtalmol. 2015;4:2:112-20.
Chansue E, Tanehsakdi M, Swasdibutra S, McAlinden C. Efficacy, predictability and safety of small incisión lenticule extraction (SMILE). Eye Vis. 2015;2:14.
Aristeidou A, Taniguchi EV, Tsatsos M, Muller R, McAlinden C, Pineda R, et al. The evolution of corneal and refractive surgery with the femtosecond laser. Eye Vis. 2015;2:12.
Reinstein DZ, Archer TJ, Gobbe M, Johnson N. Accuracy and reproducibility of Artemis central flap thickness and visual outcomes of LASIK with the Carl zeiss meditec VisuMax femtosecond laser and MEL 80 excimer laser platforms. J Refract Surg. 2010;26:107-19.
Reinstein DR, Archer TJ, Gobbe M. Small incision lenticule extraction (SMILE) history, fundamentals of a new refractive surgery technique and clinical outcomes. Eye Vis. 2014;1:3.
Ivarsen A, Asp S, Hjortdal J. Safety and Complications of More Than 1500 small incision lenticule extraction procedures. Am Acad Ophtalmol. 2014;121:4.
Wang B, Naidu RK, Chu R, Dai J, Qu X, Zhou H. Dry eye disease following refractive surgery: A 12-month follow-up of SMILE versus FS-LASIK in high myopia. J Ophtalmol. 2015; 2015:132417.
Reinstein DZ, Archer TJ, Dickeson ZI, Gobbe M. Trans-epithelial phototherapeutic keratectomy protocol for treating irregular astigmatism based population on epithelial thickness measurements by Artemis very high- frequency digital ultrasound. J Refract Surg. 2014;30:380-7.
Ekktet Chansue, Morakot Tenehsakdi, Sukanda Swasdibutra, Colm McAlinden. Safety and efficacy of VisuMax circle patterns for flap creation and enhancement following small incision lenticule extraction. Eye Vis. 2015;2:21.
Marcus Blum, Kathrin Täubig, Christin Gruhn, Walter Sekundo, Kathleen S Skunert. Five-year results of small incision lenticule extraction (SMILE). Ophtalmol. 2016;0:1-4.
Moshirfar M, McCaughey MV, Reinstein DZ, Shah R, Santiago-Caban L, Fenzl CR. Small-incision lenticule extraction. Cataract Refract Surg. 2015;41:652-65.
Wang Y, Ma J, Zhang J, Dou R, Zhang H, Li L, et al. Incidence and management of intraoperative complications during small-incision lenticule extraction in 3004 cases. J Cataract Refract Surg. 2017;43(6):796-802.
Wong CW, Chan C, Tan D, Mehta JS. Incidence and management of suction loss in refractive lenticule extraction. J Cataract Refract Surg. 2014;40(12):2002-10.
Osman IM, Awad R, Shi W, Abou Shousha M. Suction loss during femtosecond laser-assisted small-incision lenticule extraction: Incidence and analysis of risk factors. J Cataract Refract Surg. 2016;42:246-50.
Ivarsen A, Sven A, Hjortdal J. Safety and Complications of More Than 1500 small incision lenticule extraction procedures. Ophtalmology. 2014;121:4.
Ramirez-Miranda A, Ramirez-Luquin T, Navas A, Graue-Hernández EO. Refractive Lenticule Extraction Complications. Cornea. 2015;34(Suppl): S65-7.
Hamed AM, Abdelwahab SM, Soliman TT. Intraoperative complications of refractive small incision lenticule extraction in the early learning curve. Clin Ophthalmol. 2018;12:665-8.
Qiu PJ, Yang YB. Early changes to dry eye and ocularsurface after small- incision lenticule extraction for myopia. Int J Ophtalmol. 2016;9:575-9.
Chehaibou I, Sandali O, Ameline B, Bouheraoua N, Borderie V, Laroche L. Bilateral infectious keratitis after small-incision lenticule extraction. J Cataract Refract Surg. 2016;42:626-30.
Llovet F, de Rojas V, Interlandi E, Martin C, Cobo-Soriano R, Ortega-Usobiaga J, et al. Infectious keratitis in 204,586 LASIK procedures. Ophtalmology. 2010;117:232-238.e1-4.
Han T, Zheng K, Chen Y, Gao Y, He L, Zhou X. Four-year observation of predictability and stability of small incision lenticule extraction. Ophthalmology. 2016;16:149.