Femtosecond laser refractive lenticule extraction (ReLEx) is a novel procedure for treatment of myopia and myopic astigmatism, which eliminates the use of microkeratome and excimer laser. Currently there are two techniques: FLEx – femtosecond lenticule extraction (similar to conventional LASIK) and SMILE – small incision lenticule extraction, where no flap is created. This article describes surgical complications of both techniques in a retrospective review. In the FLEx group 18.3% of patients suffered intraoperative complications: suction loss, black spots (resulting in incomplete cleaving surface), bubbles in the interface, and lenticule misdissection. In the SMILE group 26.9% of patients experienced complications: epithelial defect, suction loss, opaque bubble layer, cap rupture, and lenticule rupture. Most of the reported problems were thought to be due to surgeons’ learning curve with no unfavourable long-term effects over mean follow-up of 36 months. Black spots and bubbles in the interface were classed as mild complications with no lasting effects on vision, however, the actual visual acuities or other long-term sequels were not reported. ReLEx procedures are gaining popularity as they have certain advantages over conventional LASIK. However, they carry a set of unique complications, resulting from femtosecond laser’s mode of action, and their initial learning curve has high intraoperative complications.
Surgical complications of ReLEx
Reviewed by Magdalena Popiela
Refractive lenticule extraction complications.
