Management after two consecutive suction losses during small-incision lenticule extraction: A case report

Suction loss is a small-incision lenticule extraction (SMILE) surgery complication which may compromise postoperative visual quality. Most instances of intraoperative suction loss can be promptly remedied; however, the reports of two consecutive suction losses leading to an incomplete procedure are limited. In the present case report a 24-year-old man underwent SMILE at the General Hospital of Ningxia Medical University (Yinchuan, China); the surgery was successfully completed in the right eye, nevertheless, the left eye experienced two consecutive suction losses, resulting in incomplete treatment. At ~1.5 months post operation, the patient presented to The First Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) where the treating physicians were unaware of the exact details of the first procedure. At that time, the uncorrected distance visual acuity in the left eye was 20/400, and the corrected distance visual acuity was 20/16. Subsequently, the patient received femtosecond laser-assisted in situ keratomileusis surgery for the left eye. At the 1-month postoperative visit, the uncorrected distance visual acuity had improved to 20/13. The present case demonstrates that suction loss carries a certain probability (0.17-5.06%) during SMILE, with two consecutive intraoperative suction losses being even more uncommon; however, with remedial measures, favorable postoperative visual outcomes can be secured.