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Clinical Observations and Treatment of Lens Residue after Femtosecond Laser Small Incision Lenticule Extraction |
Mengjun Fu, Haorun Zhang |
Weifang Eye Hospital,Weifang 261000, China |
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Abstract Objective: To investigate clinical treatment for lens residue after femtosecond laser small incision lenticule extraction (SMILE). Methods: Retrospective cases series study. A total of 288 patients (557 eyes) who underwent SMILE surgery in Weifang Eye Hospital from August 1 to 29, 2020 were selected for routine perioperative management. The lenticule residual retained was recorded postoperatively. Results: Two hundred eighty-eight patients (557 eyes) underwent surgery. Uncorrected visual acuity 1 day after surgery was -0.2-0.2, with an average of -0.026±0.075 (LogMAR). One month after surgery, the visual acuity of the naked eye was -0.2-0.2, with an average of -0.062±0.055 (LogMAR). The residual spherical equivalent refractive errors were -1.00-+1.00 D on the 1st day after surgery, with an average of +0.11±0.43 D. The residual spherical equivalent refractive errors were -1.00-+1.00 D one month after surgery, with an average of +0.20±0.36 D. There was lenticule residual retention in 6 eyes (1%). Among the cases with lenticule residual retention, 4 eyes had good visual acuity and the residual was in a short strip close to the peripheral area. The visual acuity of one naked eye was 1.0, but the postoperative residual refractive index was large. Pentacam showed corneal irregularity and the lenticule residual retention could be observed with anterior segment optical coherence tomography (AS-OCT). Then a secondary extraction was performed. One eye lost suction when the lenticule edge cut was completed; suction was restored immediately and laser scanning was completed. However, the lenticule separation and removal was difficult. The visual acuity of the naked eye was poor postoperatively. Pentacam showed corneal irregularity and AS-OCT showed the lenticule residual retained. The patient refused further treatment and was followed up. Conclusions: SMILE has a low incidence of partially retained lenticule. Satisfactory results can still be obtained by proper disposal of residual lenses.
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Received: 20 October 2020
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Corresponding Authors:
Haorun Zhang, Weifang Eye Hospital,Weifang 261000, China (Email: 275590026@ qq.com)
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[1] |
Slade SG. Applications for the femtosecond laser in corneal surgery. Curr Opin Ophthalmol, 2007, 18(4): 338-341. DOI: 10.1097/ICU.0b013e3281bd88b2.
|
[2] |
Qin B, Zhao J, Li M, et al. The comparison of visual outcomes, aberrations, and Bowman's layer micro-distortions after femtosecond laser small-incision lenticule extraction (SMILE) for the correction of high and moderate myopia and myopic astigmatism. BMC Ophthalmol, 2019, 19(1): 138. DOI: 10.1186/s12886-019-1135-9.
|
[3] |
Jin Y, Wang Y, Xu L, et al. Comparison of the optical quality between small incision lenticule extraction and femtosecond laser LASIK. J Ophthalmol, 2016, 2016: 2507973. DOI: 10.1155/2016/2507973.
|
[4] |
Wu D, Wang Y, Zhang L, et al. Corneal biomechanical effects: Small-incision lenticule extraction versus femtosecond laserassisted laser in situ keratomileusis. J Cataract Refract Surg, 2014, 40(6): 954-962. DOI: 10.1016/j.jcrs.2013.07.056.
|
[5] |
Krueger RR, Meister CS. A review of small incision lenticule extraction complications. Curr Opin Ophthalmol, 2018, 29(4): 292-298. DOI: 10.1097/ICU.0000000000000494.
|
[6] |
王雁. “全飞秒激光技术”的最新发展及其在SMILE手术中的应用. 中华眼视光学与视觉科学杂志, 2014, 16(7): 388-393. DOI: 10.3760/cma.j.issn.1674-845X.2014.07.002.
|
[7] |
Liu T, Lu G, Chen K, et al. Visual and optical quality outcomes of SMILE and FS-LASIK for myopia in the very early phase after surgery. BMC Ophthalmol, 2019, 19(1): 88. DOI: 10.1186/ s12886-019-1096-z.
|
[8] |
Gertnere J, Solomatin I, Sekundo W. Refractive lenticule extraction (ReLEx flex) and wavefront-optimized femto-LASIK: Comparison of contrast sensitivity and high-order aberrations at 1 year. Graefes Arch Clin Exp Ophthalmol, 2013, 251(5): 1437- 1442. DOI: 10.1007/s00417-012-2220-4.
|
[9] |
Sekundo W, Kunert K, Russmann C, et al. First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia: Six-month results. J Cataract Refract Surg, 2008, 34(9): 1513-1520. DOI: 10.1016/j.jcrs.2008.05.033.
|
[10] |
Xu Y, Yang Y. Dry eye after small incision lenticule extraction and LASIK for myopia. J Refract Surg, 2014, 30(3): 186-190. DOI: 10.3928/1081597X-20140219-02.
|
[11] |
Dong Z, Zhou X, Wu J, et al. Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: Comparison of corneal wound healing and inflammation. Br J Ophthalmol, 2014, 98(2): 263-269. DOI: 10.1136/bjophthalmol-2013-303415.
|
12 |
] Yao P, Zhao J, Li M, et al. Microdistortions in Bowman's layer following femtosecond laser small incision lenticule extraction observed by Fourier-Domain OCT. J Refract Surg, 2013, 29(10): 668-674. DOI: 10.3928/1081597X-20130806-01.
|
[13] |
李彩红, 赵宏, 帖彪, 等. 飞秒激光微切口角膜基质透镜取出术术后并发症分析及处理. 国际眼科杂志, 2018, 18(4): 713- 715. DOI: 10.3980/j.issn.1672-5123.2018.4.30.
|
[14] |
Titiyal JS, Kaur M, Rathi A, et al. Learning curve of small incision lenticule extraction: Challenges and complications. Cornea, 2017, 36(11): 1377-1382. DOI: 10.1097/ICO. 0000000000001323.
|
[15] |
Lin L, Weng S, Liu F, et al. Development of low laser energy levels in small-incision lenticule extraction: Clinical results, black area, and ultrastructural evaluation. J Cataract Refract Surg, 2020, 46(3): 410-418. DOI: 10.1097/j.jcrs.0000000000000071.
|
[16] |
邢星, 李世洋, 赵爱红, 等. 小切口角膜基质透镜取出术1 000 只眼并发症的观察. 中华眼外伤职业眼病杂志, 2017, 39(8): 619-622. DOI: 10.3760/cma.j.issn.2095-1477.2017.08.016.
|
[17] |
苏才培, 杨亚波. 飞秒激光小切口角膜基质透镜取出术操作要点及并发症的预防和处理. 山东大学耳鼻喉眼学报, 2020, 34(2): 13-16. DOI: 10.6040/j.issn.1673-3770.1.2020.007.
|
[18] |
中华医学会眼科学分会眼视光学组. 我国飞秒激光小切口角膜基质透镜取出手术规范专家共识(2018年). 中华眼科杂志, 2018, 54(10): 729-736. DOI: 10.3760/cma.j.issn.0412-4081. 2018.10.003.
|
[19] |
张丰菊. 合理开展飞秒激光角膜屈光手术防范并发症. 中华眼科杂志, 2014, 50(4): 241-243. DOI: 10.3760/cma.j.issn. 0412-4081.2014.04.001.
|
[20] |
李莹. 重视激光角膜屈光手术快速发展中的手术并发症问题. 中华眼科杂志, 2018, 54(10): 721-725. DOI: 10.3760/cma. j.issn.0412-4081.2018.10.001.
|
[1] |
. [J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 0-. |
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