Ihab M Osman1, Ramy Awad2, Wei Shi2, Mohamed Abou Shousha2. 1. From the Department of Ophthalmology (Osman, Awad, Shousha), Faculty of Medicine, University of Alexandria, Egypt; the Bascom Palmer Eye Institute (Shi, Shousha), University of Miami, Miller School of Medicine, Miami, Florida, USA. Electronic address: osmanehab@yahoo.com. 2. From the Department of Ophthalmology (Osman, Awad, Shousha), Faculty of Medicine, University of Alexandria, Egypt; the Bascom Palmer Eye Institute (Shi, Shousha), University of Miami, Miller School of Medicine, Miami, Florida, USA.
Abstract
PURPOSE: To determine the incidence of and analyze risk factors for suction loss during femtosecond laser-assisted small incision lenticule extraction in the management of myopia or myopic astigmatism. SETTING: Roayah Vision Correction Center, Alexandria, Egypt. DESIGN: Retrospective comparative case-control study. METHODS: All eyes that had femtosecond laser-assisted small-incision lenticule extraction for the correction of myopia and myopic astigmatism performed between August 2010 and April 2014 were included. Eyes that developed suction loss were identified. Their characteristics, including demographic data (age and sex), eye laterality, manifest refraction, flat keratometry (K) reading, steep K reading, K astigmatism, optical zone, central corneal thickness, and corneal cap diameter and thickness, were compared with those in randomly selected control eyes to determine the risk factors for developing suction loss. RESULTS: Of the 3376 eyes that had femtosecond laser-assisted small-incision lenticule extraction during the study, 70 (2.1%) developed loss of suction. The incidence decreased with surgical experience (5.06% in 2010, 3.59% in 2011, 3.41% in 2012, 2.32% in 2013, and 1.84% in 2014), suggesting a learning curve. A multivariate logistic regression model showed that eyes with a larger cap diameter were significantly more likely to develop suction loss (P = .023; odds ratio, 9.60). CONCLUSIONS: Surgical experience significantly decreased the risk for suction loss during femtosecond laser-assisted small incision lenticule extraction for the correction of myopia or myopic astigmatism but did not eliminate it. A larger cap diameter significantly increased the risk for developing the suction loss. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
PURPOSE: To determine the incidence of and analyze risk factors for suction loss during femtosecond laser-assisted small incision lenticule extraction in the management of myopia or myopic astigmatism. SETTING: Roayah Vision Correction Center, Alexandria, Egypt. DESIGN: Retrospective comparative case-control study. METHODS: All eyes that had femtosecond laser-assisted small-incision lenticule extraction for the correction of myopia and myopic astigmatism performed between August 2010 and April 2014 were included. Eyes that developed suction loss were identified. Their characteristics, including demographic data (age and sex), eye laterality, manifest refraction, flat keratometry (K) reading, steep K reading, K astigmatism, optical zone, central corneal thickness, and corneal cap diameter and thickness, were compared with those in randomly selected control eyes to determine the risk factors for developing suction loss. RESULTS: Of the 3376 eyes that had femtosecond laser-assisted small-incision lenticule extraction during the study, 70 (2.1%) developed loss of suction. The incidence decreased with surgical experience (5.06% in 2010, 3.59% in 2011, 3.41% in 2012, 2.32% in 2013, and 1.84% in 2014), suggesting a learning curve. A multivariate logistic regression model showed that eyes with a larger cap diameter were significantly more likely to develop suction loss (P = .023; odds ratio, 9.60). CONCLUSIONS: Surgical experience significantly decreased the risk for suction loss during femtosecond laser-assisted small incision lenticule extraction for the correction of myopia or myopic astigmatism but did not eliminate it. A larger cap diameter significantly increased the risk for developing the suction loss. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
Authors: Tommy C Y Chan; Kelvin H Wan; David S Y Kang; Tiffany H K Tso; George P M Cheng; Yan Wang Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-10-27 Impact factor: 3.117