A review of small incision lenticule extraction complications

Current Opinion in Ophthalmology
Ronald R Krueger, Caio S Meister

Abstract

As a flapless procedure, SMILE brings benefits to refractive surgery, such as lower corneal biomechanical impact, less dry eye risk and less stromal bed exposure. However, the longer learning curve can be a risk factor for complications. This article aims to discuss SMILE complications and proposes a categorized analysis of occurrences, dividing into two groups: intraoperative and postoperative complications. Among intraoperative, we also suggest a subdivision between those related to the laser (lenticule construction), tissue separation (lenticule dissection) and tissue removal (lenticule extraction). The majority of SMILE complications are related to surgeon inexperience and reversible if precociously diagnosed and correctly managed. Intraoperative complications related to lenticule creation such as suction loss, opaque bubble layer and black spots, are correlated with later difficulties during lenticule dissection and removal, and may lead to unwanted situations, such as cap perforation, lenticule tear and cap-lenticule adhesion. Postoperative complications as dry eye, keratitis and ectasia should not be underestimated. Analyzing what has been reported as major or unique among the complications with SMILE, and dividing them ...Continue Reading

References

May 22, 2013·Journal of Cataract and Refractive Surgery·Zixian Dong, Xingtao Zhou
Mar 22, 2014·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Walter SekundoIgor Solomatin
Apr 26, 2014·Journal of Refractive Surgery·Yesheng Xu, Yabo Yang
Feb 11, 2015·Journal of Cataract and Refractive Surgery·Jing ZhaoXingtao Zhou
Mar 26, 2015·Journal of Cataract and Refractive Surgery·Majid MoshirfarCarlton R Fenzl
Aug 1, 2015·Cornea·Arturo Ramirez-MirandaEnrique O Graue-Hernandez
Mar 31, 2016·Journal of Cataract and Refractive Surgery·Ihab M OsmanMohamed Abou Shousha
Apr 27, 2016·Journal of Cataract and Refractive Surgery·Ismaël ChehaibouLaurent Laroche
Oct 5, 2016·Journal of Cataract and Refractive Surgery·Soosan JacobAthiya Agarwal
Oct 11, 2016·Journal of Refractive Surgery·Manli LiuQuan Liu
Jul 25, 2017·Journal of Cataract and Refractive Surgery·Yan WangPinghui Wei
Oct 6, 2017·Clinical Ophthalmology·Majid MoshirfarPhillip C Hoopes
Nov 9, 2017·Journal of Refractive Surgery·Liuyang LiYan Wang
Nov 9, 2017·Journal of Refractive Surgery·Alex L K NgTommy C Y Chan
Nov 9, 2017·Journal of Refractive Surgery·Jayanand UrkudeNamrata Sharma

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Citations

Apr 30, 2019·Current Opinion in Ophthalmology·Majid MoshirfarTirth Shah
Sep 10, 2020·Journal of Refractive Surgery·De WuXuejun Fang
Nov 7, 2019·Vestnik oftalmologii·V M SheludchenkoR A Dzhalili
Nov 25, 2020·Indian Journal of Ophthalmology·Gitansha S Sachdev, Shreyas Ramamurthy
Oct 1, 2019·Asia-Pacific Journal of Ophthalmology·Quan LiuDennis S C Lam
Feb 1, 2021·Experimental Eye Research·Kareem SioufiKarolinne M Rocha
Aug 31, 2021·Biomedical Optics Express·Samuel Arba-MosqueraShwetabh Verma
Feb 13, 2021·Journal of Cataract and Refractive Surgery·Travis S DowdleBryan K Monson
Nov 11, 2021·Journal of Refractive Surgery·Vardhaman P KankariyaPravin K Vaddavalli

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