Intraoperative Microkeratome Complications in 47,094 Laser in situ Keratomileusis Surgeries

Nakano, Kozo; Nakano, Eliane Mayumi; Oliveira, Marivaldo; Portellinha, Waldir; Alvarenga, Lênio Souza

doi:10.3928/1081-597x-20040903-19

Cited by 49 publications

(17 citation statements)

References 13 publications

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“…[4][5][6] Flap complication rates have been reported from 0.3% to 14%, depending on the microkeratome and surgeons involved. [7][8][9][10][11] Few studies were found regarding the relationship between fl ap complication rates and preoperative keratometric power. 2,5 Results of patients having undergone LASIK at our centers with a manual, mechanical microkeratome (Moria LSK One; Moria, Antony, France) were analyzed to assess the relationship between preoperative keratometric power and intraoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes

Albelda-Vallés¹,

Martin-Reyes²,

Ramos³

et al. 2007

J Refract Surg

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PURPOSE: To evaluate the effect of preoperative keratometric power on the intraoperative complications in LASIK for myopia, hyperopia, and astigmatism. METHODS: In this retrospective study, the records of 34,099 eyes of 17,388 patients who underwent LASIK for myopia, hyperopia, and astigmatism using the Moria LSK One manual microkeratome and the Bausch & Lomb Technolas 217 Z excimer laser were reviewed.

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Section: Discussionmentioning

confidence: 99%

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes

Albelda-Vallés¹,

Martin-Reyes²,

Ramos³

et al. 2007

J Refract Surg

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“…Out of 17 243 LASIK procedures, there were 86 cases of suction loss, which gives exactly the same incidence of 0.50% that was found for SMILE. Table 6 shows the published suction loss incidence for the IntraLase femtosecond laser (Johnson & Johnson Vision, Jacksonville, FL, USA) (Binder 2006;Chang 2008;Sutton & Hodge 2008;Haft et al 2009;Davison & Johnson 2010;Moshirfar et al 2010;Kohnen et al 2016) and the Hansatome microkeratome (Bausch & Lomb, Rochester, NY, USA) (Jacobs & Taravella 2002;Nakano et al 2004;Moshirfar et al 2010;Al-Mezaine et al 2011) for studies with a population of more than 750 eyes. The overall suction loss rate was found to be 0.18-0.19% for both, which is just over half the rate for SMILE.…”

Section: Discussionmentioning

confidence: 99%

Suction stability management in small incision lenticule extraction: incidence and outcomes of suction loss in 4000 consecutive procedures

Reinstein

Archer

Vida

et al. 2019

Acta Ophthalmologica

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Purpose: To report the incidence and outcomes of suction loss during small incision lenticule extraction (SMILE). Methods: The incidence of suction loss was measured over 4000 consecutive SMILE procedures and categorized by cause, the interface in which suction was lost and management (restart/continue SMILE, re-SMILE thinner cap, convert to laser in-situ keratomileusis [LASIK]). One-year outcomes were compared to the fellow eye where no suction loss occurred. Results: There were 20 cases of suction loss (0.50%): during the lenticule interface in seven eyes, lenticule side cut in one eye, cap interface in nine eyes and small incision for three eyes. Small incision lenticule extraction (SMILE) was continued in seven eyes, thinner cap SMILE in four eyes, LASIK in eight eyes, and the small incision was manually completed in one eye. Suction loss was caused by a Bell's reflex in 10 eyes, fixation light tracking in six eyes, patient anxiety in two eyes, a nociceptive reflex in one eye and false suction in one eye. There was no difference in results for suction loss and fellow eyes, respectively: uncorrected distance visual acuity was 20/20 or better in 100% in both groups, spherical equivalent was within AE0.50 D in 85% and 79%, one line loss of corrected distance visual acuity in 5% and 0%, and no eyes lost two lines. Conclusion: Suction loss can be managed depending on the interface during which suction is lost. Treatment was completed on the same day in all instances. Visual and refractive outcomes were unaffected compared to the fellow eye in this series. PatientsThis was a retrospective non-comparative case series of all myopic SMILE e72 Acta Ophthalmologica 2020

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“…Операции ЛАЗИК присущи недостатки, которые, главным образом, координированы с работой микрокератома: тонкий неравномерный клапан, прободение (button hole), микрострии, децентрация, смещение клапана, полный (free flap) и неполный срез клапана, индуцированная кератэктазия, обнаружение микрочастиц металла в роговице. Все это, несомненно, сказывается на качестве зрительных функций в послеоперационном периоде [14][15][16][17].…”

Section: эволюция современных методов лазерной хирургии роговицыunclassified

Current View on the Postoperative Asthenopic Syndrome Problem in Patients with Corneal Refractive Surgery. Review

et al. 2019

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Laser technologies of corneal surgery perfection was one of the important events in ophthalmology in the past decades. Despite to the significant success in refractive surgery and the achieved high result in visual acuity, the ideal healing of the cornea, the absence of dry eye syndrome, some patients in the postoperative period present asthenopic complaints. Patients may notice a decrease in visual acuity when working near, difficulty in refocusing from far to near distance, fuzzy, blurred images, red eyes, tearing, periodic or permanent diplopia at different distances in the postoperative period. Adaptation to emmetropic refraction in these patients can cause discomfort, headache and visual fatigue even with insignificant visual loads, which leads to the development of asthenopia and worsening of their subjective status. Corneal refractive surgery leads to changes in the anatomical and optic parameters of the eye, which contributes to the formation of new accommodation-convergence interactions. If the accommodative and binocular functions were disrupted preoperatively, there is a risk of decompensation and development of postoperative asthenopic syndrome (AS). Refractive surgery, saving patients from glasses and contact lenses, can not completely eliminate their existing imbalances between accommodation and convergence. This can be explained with the fact that the existence of a formed pathological system does not cease with the elimination of the etiologic factor. In order to correct the disturbed parameters, additional research methods and effective methods of functional treatment of patients in the postoperative period were suggested. However, most of them are aimed at pathogenetic effects on accommodative muscles, often without taking into account disturbances in the oculomotor apparatus and binocular function. Thus, existing algorithms for investigating and managing patients with refractive disorders do not allow us to identify predictors for the development of asthenopia before refractive surgery, there is no set of preventive restoration measures aimed at restoring accommodative capacity and binocular interaction in the preoperative period to increase satisfaction with the results of surgery in patients at risk of postoperative AS.

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Intraoperative Microkeratome Complications in 47,094 Laser in situ Keratomileusis Surgeries

Cited by 49 publications

References 13 publications

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes

Suction stability management in small incision lenticule extraction: incidence and outcomes of suction loss in 4000 consecutive procedures

Current View on the Postoperative Asthenopic Syndrome Problem in Patients with Corneal Refractive Surgery. Review

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