Comparison of immediate small-incision lenticule extraction after suction loss with uneventful small-incision lenticule extraction

Abstract

To evaluate and compare the predictability and safety of immediate small-incision lenticule extraction, also known as SMILE, after suction loss during the procedure with those of uneventful small-incision lenticule extraction. Nunemiso Eye Center, Seoul, South Korea. Retrospective case series. Patients who had immediate small-incision lenticule extraction using reapplied suction (study group) or uneventful small-incision lenticule extraction (control group) for myopia or myopic astigmatism were included. All patients were followed for at least 12months. Demographic as well as visual and refractive outcomes were compared between the 2 groups. Twenty-three eyes were enrolled in the study group and 48 eyes in the control group. The overall cumulative incidence of suction loss was 0.2% (28 of 11 762 eyes). Twenty-two eyes (96%) in the study group had unchanged or improved decimal Snellen corrected distance visual acuity (CDVA). At 12months, the mean uncorrected distance visual acuity, CDVA, and manifest refraction defocus equivalent in the study group and control group were 0.99±0.17 (SD), 1.11±0.14, 0.75±0.50 diopters (D), and 1.25±0.22 D, 1.26±0.21 D, 0.35±0.26 D, respectively (P=.000, P=.007, and P=.000, respectively). The correlation between the achieved and the attempted spherical equivalent refraction was slightly better in the control group (R2=0.972) than in the study group (R2=0.933). Immediate small-incision lenticule extraction using reapplied suction resulted in safe and clinically predictable long-term outcomes. However, predictability was lower for immediate than for uneventful small-incision lenticule extraction.