Revention and Management of Complications in the Perioperative Period of SMILE

Cuixia Li, Junhua Hao
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Abstract

Objective: To analyze the data of femtosecond laser small incision corneal stroma lens extractions (SMILE) performed in Aiyan Ophthalmology Hospital, summarize the intraopearative and postoperative complications and treatment. Methods: From January 2018 to November 2018, SMILE surgery was performed on 515 cases (1015 eyes) of myopia or astigmatism in Aiyan Ophthalmology Hospital in this retrospective series of case studies. A retrospective analysis of the occurrence of intraoperative and postoperative complications was performed. Results: The overall incidence of complications was 7.88%, of which 2 eyes (0.19%) were negatively affected by negative pressure, scans showed 3 eyes (0.29%) had black areas, 12 eyes (1.18%) had an incision tear, in 7 eyes (0.68%) the corneal stroma lens was difficult to find, 5 eyes (0.49%) had a residual lens, 32 eyes (3.10%) had an epithelial defect from the incision, 5 eyes (0.49%) had bleeding in the incision area, 10 eyes (0.98%) had diffuse lamellar keratitis, 1 eye (0.09%) had an intersegmental epithelial implantation, and 3 eyes (0.29%) had the remains of foreign matter under the corneal cap. Vision was restored after appropriate treatment for complications to achieve the best corrected visual acuity. Conclusion: SMILE surgery as a new type of corneal refractive surgery for the treatment of myopic astigmatism has few complications. Effective prevention and treatment of intraoperative and postoperative complications is essential for surgical safety. Key words: femtosecond laser small incision corneal stroma lens extraction; complications; prevention
SMILE围手术期并发症的预防与处理
目的:分析艾燕眼科医院飞秒激光小切口角膜基质晶状体摘除术(SMILE)的手术资料,总结术中、术后并发症及处理方法。方法:回顾性分析2018年1月至11月在艾燕眼科医院对515例(1015眼)近视或散光患者行SMILE手术。回顾性分析术中及术后并发症的发生情况。结果:并发症总发生率为7.88%,其中负压不良2眼(0.19%),扫描示黑色区3眼(0.29%),切口撕裂12眼(1.18%),角膜基质晶状体难以发现7眼(0.68%),晶状体残留5眼(0.49%),切口上皮缺损32眼(3.10%),切口出血5眼(0.49%),弥漫性板层角膜炎10眼(0.98%)。1眼(0.09%)有节段间上皮植入,3眼(0.29%)有角膜帽下异物残留。术后并发症适当处理后视力恢复,达到最佳矫正视力。结论:SMILE手术作为治疗近视散光的一种新型角膜屈光手术,并发症少。有效预防和治疗术中及术后并发症对手术安全至关重要。关键词:飞秒激光小切口角膜基质晶状体摘除;并发症;预防
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