https://doi.org/10.4081/ltj.2023.322

Incidence and outcome of suction loss during corneal lenticule extraction with the femtosecond laser application CLEAR

Vol. 30 No. 1 (2023)
Submitted: 4 August 2023
Accepted: 21 August 2023
Published: 4 September 2023
Myopia, LASIK, corneal lenticule extraction, suction loss
Abstract Views: 2913
pdf: 34
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Authors

Antonio Leccisotti
leccisotti@libero.it
https://orcid.org/0000-0001-9953-0535
Siena Eye Laser, Poggibonsi, Siena, Italy; Scuola di Specializzazione in Oftalmologia, Università di Siena, Siena, Italy; School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom.
Stefania V. Fields
https://orcid.org/0000-0003-3886-8852
Siena Eye Laser, Poggibonsi, Siena, Italy.
Giuseppe De Bartolo
https://orcid.org/0000-0002-6666-2440
Siena Eye Laser, Poggibonsi, Siena, Italy.
Christian Crudale
https://orcid.org/0009-0006-4002-1481
Siena Eye Laser, Poggibonsi, Siena, Italy.

A femtosecond laser creates an intrastromal lenticule while the eye is immobilized by vacuum in refractive corneal lenticule extraction to correct myopia. Suction loss has a 0.72% overall incidence and may result in an incomplete cut; the procedure can then be completed using the same or different techniques. While previous laser platforms used corneal suction, the recent lenticule extraction (CLEAR) application for the Ziemer Z8 femtosecond laser (Ziemer Group, Port) uses scleral suction; studies on suction loss with this vacuum system are lacking. A total of 652 eyes from 357 CLEAR patients were thus included in a consecutive, single-institution, retrospective study. Suction loss occurred in three patients’ left eyes (0.46%) due to a strong involuntary eyelid contraction. After an early suction loss in patient #1, the procedure was successfully repeated with the same parameters. Suction loss occurred after the completion of the posterior cut and at 44% of the anterior cut in patient #2. The laser procedure appeared to have been completed in patient #3, but the lenticule had not been delineated temporally due to false suction on the conjunctiva. Thin flap femtosecond laser in situ keratomileusis (LASIK) was used to complete the refractive procedure in patients #2 and #3. Uncorrected distance visual acuity was 20/20 or better in all three eyes at 6 months. Finally, suction loss during CLEAR was uncommon and had a favorable prognosis. Repeat lenticule extraction or femtosecond LASIK can be performed on the same day to complete the treatment.

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Scopus
Google Scholar
Europe PMC
Rochkind S. Stimulation effect of laser energy on the regeneration of traumatically injured peripheral nerves. Morphogen Regen 1978;83:25-27.
Gigo-Benato D, Geuna S, Rochkind S. Phototherapy for enhancing peripheral nerve repair: a review of the literature. Muscle Nerve 2005;31:694-701. DOI: https://doi.org/10.1002/mus.20305
Rochkind S. Phototherapy in peripheral nerve regeneration: From basic science to clinical study. Neurosurg Focus 2009;26:E8. DOI: https://doi.org/10.3171/FOC.2009.26.2.E8
Shamir MH, Rochkind S, Sandbank J, Alon M. Double-blind randomized study evaluating regeneration of the rat transected sciatic nerve after suturing and postoperative low power laser treatment. J Reconstruct Microsurg 2001;17:133-138. DOI: https://doi.org/10.1055/s-2001-12702
Rochkind S, Leider-Trejo L, Nissan M, et al. Efficacy of 780-nm laser phototherapy on peripheral nerve regeneration after neurotube reconstruction procedure (double-blind randomized study). Photomed Laser Surg 2007;25:137-143. DOI: https://doi.org/10.1089/pho.2007.2076
Gigo-Benato D, Geuna S, de Castro Rodrigues A, et al. Low-power laser biostimulation enhances nerve repair after end-to-side neurorrhaphy: A double-blind randomized study in the rat median nerve model. Laser Med Sci 2004;19:57-65. DOI: https://doi.org/10.1007/s10103-004-0300-3
Rochkind S, Drory V, Alon M, et al. Laser phototherapy (780 nm), a new modality in treatment of log-term incomplete peripheral nerve injury: A randomized double-blind placebo-controlled study. Photomed Laser Surg 2007;25:436-442. DOI: https://doi.org/10.1089/pho.2007.2093
Rochkind S, Shainberg A. Protective effect of laser phototherapy on acetylcholine receptors and creatine kinase activity in denervated muscle. Photomed Laser Surg 2013;31:499-504. DOI: https://doi.org/10.1089/pho.2013.3537
Rochkind S, Geuna S, Shainberg A. Phototherapy and nerve injury: focus on muscle response. Inter Rew Neurobiol 2013;109:99-109. DOI: https://doi.org/10.1016/B978-0-12-420045-6.00004-3
Mandelbaum-Livnat M, Almog M, Nissan M, et al. Photobiomodulation triple treatment in peripheral nerve injury: nerve and muscle response. Photomed Laser Surg 2016;34:638-645. DOI: https://doi.org/10.1089/pho.2016.4095
Andreo L, Ribeiro B, Alves A, et al. Effects of photobiomodulation with low-level laser therapy on muscle repair following a peripheral nerve injury in Wistar rats. Photochem Photobiol 2020;96:1124-1132. DOI: https://doi.org/10.1111/php.13255
Almog M, Nissan M, Koifman I, et al. On-site laser photobiomodulation treatment of crushed muscle due to prolonged pressure in rats. Laser Surg Med 2021;53:1258-1265. DOI: https://doi.org/10.1002/lsm.23417
Falcai MJ, Monte-Raso VV, Okubo R, et al. Biomechanical and histological analysis of the gastrocnemius in rats subjected to muscle injury and treatment with low-level laser therapy. Rev Bras Ortop 2010;45:444-448. DOI: https://doi.org/10.1016/S2255-4971(15)30395-5
Rizzi CF, Mauriz JL, Freitas Corrêa DS, et al. Effects of low-level laser therapy (LLLT) on the nuclear factor (NF)-kappaB signaling pathway in traumatized muscle Lasers Surg Med 2006;38:704-713. DOI: https://doi.org/10.1002/lsm.20371
Silveira PC, da Silva LA, Pinho CA, et al. Effects of low-level laser therapy (GaAs) in an animal model of muscular damage induced by trauma. Lasers Med Sci 2013;28:431-436. DOI: https://doi.org/10.1007/s10103-012-1075-6
Iyomasa DM, Garavelo I, Iyomasa MM, et al. Ultrastructural analysis of the low-level laser therapy effects on the lesioned anterior tibial muscle in the gerbil. Micron 2009;40:413-418. DOI: https://doi.org/10.1016/j.micron.2009.02.002

How to Cite

Leccisotti, A., Fields, S. V., De Bartolo, G., & Crudale, C. (2023). Incidence and outcome of suction loss during corneal lenticule extraction with the femtosecond laser application CLEAR. Laser Therapy, 30(1). https://doi.org/10.4081/ltj.2023.322
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