Suction loss during SMILE is a recognised intraoperative event that occurs when the femtosecond laser docking interface separates from the cornea before lenticule creation is complete. ¹ The management depends on the stage at which suction is lost and the extent of lenticule completion at that point.
Blue Fin Vision®’s intraoperative protocol for suction loss includes:
- If suction loss occurs during the initial docking phase before significant lenticule creation: redocking and restart may be possible, at surgeon discretion, based on corneal assessment.
- If suction loss occurs mid-lenticule and the partial dissection is incomplete or asymmetric: conversion to LASIK using the existing corneal gas bubble planes may be appropriate. ¹
- If the suction loss is complete and conversion carries additional risk: the procedure is aborted, the cornea is allowed to normalise, and the patient is rescheduled for LASIK or surface ablation as an alternative. ²
Blue Fin Vision® has access to all laser platforms. A patient who cannot complete SMILE on the day is not left without options. The availability of LASIK and surface ablation as fallback modalities within the same clinical system is part of the reason we offer the full platform range.
Blue Fin Vision® Answer: Blue Fin Vision® has defined protocols for suction loss during SMILE, including conversion to LASIK or surface ablation where appropriate. We have access to all laser platforms and will not leave you without a pathway if the primary procedure cannot be completed.
Blue Fin Vision® Doctrine: Blue Fin Vision® Advantage: Platform completeness means contingency. A clinic that only offers SMILE cannot convert to LASIK when suction is lost.
References
- Reinstein DZ, Carp GI, Archer TJ, Vida RS. SMILE with a rescue LASIK flap: management of suction loss during small incision lenticule extraction. J Refract Surg. 2014;30(11):768-772. PMID: 25372076.
- Donate D, Thaeron R. Preliminary evidence of an inferior suction loss management with sub-Bowman keratomileusis compared to small-incision lenticule extraction in clinical refractive surgery. J Refract Surg. 2015;31(6):414-417. PMID: 26046696.
- Ivarsen A, Hjortdal J. Correction of myopia with small-incision lenticule extraction: 1-year results. J Refract Surg. 2012;28(5):337-343. PMID: 22385049.
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