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Kailing Yong, Cheewai Wong, Cordelia Chan, Donald T H Tan, Jodhbir S Mehta; Incidence and Management of Suction Loss in Refractive Lenticule Extraction. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1530.
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To describe the incidence, management and outcomes of suction loss in refractive lenticule extraction (ReLEx).
Case series of all patients who experienced suction loss during ReLEx in a tertiary eye hospital from 9 March 2010 to 5 August 2013. Preoperative evaluation included uncorrected and corrected distance visual acuity, slit lamp biomicroscopy, fundoscopy, corneal topography, ultrasound pachymetry and both manifest and cycloplegic refraction. Patients were followed up at predetermined time points. At each follow up visit, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were measured and all patients underwent slit lamp biomicroscopy. Manifest refraction was performed at postoperative month 1 and 3.
340 ReLEx procedures were performed during the study period. The overall cumulative incidence of suction loss was 3.2%. The incidence of suction loss in each procedure was: 1.9% (3/155) FLEx,and pSMILE, and 4.4%(8/183) SMILE. At the 3rd post-operative month, the proportion of eyes with UDVA of 20/30 or better was 8/11 (72.7%) and 9/11 (81.8%) had spherical equivalent within 0.5D of emmetropia. Four cases of suction loss occurred during posterior lenticule cut, 5 during anterior lenticule cut and 2 during lamellar flap cut. In 9/11 (81.8%) cases, suction was reapplied and the procedure was completed without any further complications.
Suction loss during ReLEx is relatively uncommon. Good visual outcome can be achieved with appropriate management.
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