Journal of cataract and refractive surgery · 2017
Incidence and management of intraoperative complications during small-incision lenticule extraction in 3004 cases.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
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Wang Yan, Ma Jiaonan, Zhang Jiamei, Dou Rui, Zhang Hui, Li Liuyang, Zhao Wei, Wei Pinghui
Аннотация
PURPOSE: To assess the intraoperative complications during small-incision lenticule extraction (SMILE) for myopia and myopic astigmatism correction and evaluate visual outcomes 6 months postoperatively.
SETTING: Tianjin Eye Hospital, Tianjin, China.
DESIGN: Retrospective case series.
METHODS: Patients who had small-incision lenticule extraction surgery were examined 1 day, 7 days, 1 month, 3 months, and 6 months postoperatively. Demographic characteristics, visual outcomes, and intraoperative complications were recorded. Moreover, the incidence and management of the complications and the potential factors were analyzed.
RESULTS: Of the 3004 eyes (1511 patients), 134 (4.46%) had intraoperative complications, including suction loss (28 cases [0.93%]), incisional bleeding (28 cases [0.93%]), opaque bubble layer (22 cases [0.73%]), subconjunctival hemorrhage (20 cases [0.67%]), black areas (10 cases [0.33%]), unintended posterior plane dissection (10 cases [0.33%]), tearing of the lenticule (8 cases [0.27%]), abrasion at the incision (5 cases [0.17%]), and inaccurate laser pulse placement due to eye movement (3 cases [0.10%]). The complications were resolved instantaneously using appropriate management procedures; all cases had good visual outcomes. Six months postoperatively, 99.80% of cases had an uncorrected distance visual acuity better than 20/25 and the mean corrected distance visual acuity was -0.06 logarithm of the minimum angle of resolution ± 0.07 (SD).
CONCLUSIONS: Although small-incision lenticule extraction shows promising outcomes for correction of myopia and myopic astigmatism, intraoperative complications still inevitably occur. However, satisfactory visual outcomes may be achieved using appropriate management techniques.
SETTING: Tianjin Eye Hospital, Tianjin, China.
DESIGN: Retrospective case series.
METHODS: Patients who had small-incision lenticule extraction surgery were examined 1 day, 7 days, 1 month, 3 months, and 6 months postoperatively. Demographic characteristics, visual outcomes, and intraoperative complications were recorded. Moreover, the incidence and management of the complications and the potential factors were analyzed.
RESULTS: Of the 3004 eyes (1511 patients), 134 (4.46%) had intraoperative complications, including suction loss (28 cases [0.93%]), incisional bleeding (28 cases [0.93%]), opaque bubble layer (22 cases [0.73%]), subconjunctival hemorrhage (20 cases [0.67%]), black areas (10 cases [0.33%]), unintended posterior plane dissection (10 cases [0.33%]), tearing of the lenticule (8 cases [0.27%]), abrasion at the incision (5 cases [0.17%]), and inaccurate laser pulse placement due to eye movement (3 cases [0.10%]). The complications were resolved instantaneously using appropriate management procedures; all cases had good visual outcomes. Six months postoperatively, 99.80% of cases had an uncorrected distance visual acuity better than 20/25 and the mean corrected distance visual acuity was -0.06 logarithm of the minimum angle of resolution ± 0.07 (SD).
CONCLUSIONS: Although small-incision lenticule extraction shows promising outcomes for correction of myopia and myopic astigmatism, intraoperative complications still inevitably occur. However, satisfactory visual outcomes may be achieved using appropriate management techniques.