Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies

  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
May-2026 Volume 31 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
May-2026 Volume 31 Issue 5

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Case Report

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

  • Authors:
    • Luanying Wei
    • Tiantian Qi
    • Nan Li
    • Qiang Shi
    • Shengjian Mi
    • Cheng Pei

  • View Affiliations / Copyright

    Affiliations: Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
  • Article Number: 126
    |
    Published online on: March 3, 2026
       https://doi.org/10.3892/etm.2026.13122
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:


Abstract

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.
View Figures

Figure 1

Cap thickness of the left eye after SMILE measured by anterior segment optical coherence tomography. ‘Cap’ refers to the thin corneal tissue layer retained post-lenticule removal in SMILE. SMILE, small-incision lenticule extraction.

Figure 2

Intraoperative images for the first suction losses during SMILE surgery on the left eye. All images are presented from the perspective of the surgeon and appear upside down (a common presentation of surgical microscopic views). (A) A small part of the bulbar conjunctiva (white arrow; the bulbar conjunctiva is a thin, transparent membrane covering the outer surface of the eyeball). (B) A slight upward displacement (<0.3 mm) of the eye position (white arrow; eye position displacement refers to the slight movement of the eyeball from its ideal surgical position during the operation). (C) The eye position shifted upward ~1 mm (white arrow). (D) The progressive first suction loss occurred (suction loss refers to a condition in SMILE surgery where the surgical suction ring loses stable adherence to the eye, which may affect the subsequent surgical steps). SMILE, small-incision lenticule extraction.

Figure 3

Intraoperative images for the second suction losses during SMILE surgery on the left eye. All images are presented from the perspective of the surgeon and appear upside down. (A) The cutting line of the lens edge (white arrow; the lenticule is a small, lens-shaped corneal tissue fragment removed during SMILE surgery) and the presence of bubble dispersion plus bulbar conjunctiva (blue arrow; bubble dispersion refers to the scattered distribution of small air bubbles generated during the surgical process). (B) The cap scanning was completed. (C) The cap incision was incomplete with a misaligned manner (white arrow; misaligned incision means the surgical incision for opening the corneal cap does not match the preset path, resulting in incomplete incision). SMILE, small-incision lenticule extraction.
View References

1 

Maulvi FA, Desai DT, Kalaiselvan P, Shah DO and Willcox MDP: Current and emerging strategies for myopia control: A narrative review of optical, pharmacological, behavioural, and adjunctive therapies. Eye (Lond). 39:2635–2644. 2025.PubMed/NCBI View Article : Google Scholar

2 

World Health Organization (WHO): World report on vision. World Health Organization, Geneva, 2019.

3 

Wolffsohn JS, Whayeb Y, Logan NS and Weng R: International Myopia Institute Ambassador Group*. IMI-global trends in myopia management attitudes and strategies in clinical practice-2022 update. Invest Ophthalmol Vis Sci. 64(6)2023.PubMed/NCBI View Article : Google Scholar

4 

Luensmann D, Schaeffer JL, Rumney NJ, Stanberry A and Fonn D: Magnitude of astigmatism-A comparison between eyes. Cont Lens Anterior Eye. 45(101510)2022.PubMed/NCBI View Article : Google Scholar

5 

Song J, Cao H, Chen X, Zhao X, Zhang J, Wu G and Wang Y: Small incision lenticule extraction (SMILE) versus laser assisted stromal in situ keratomileusis (LASIK) for astigmatism corrections: A systematic review and meta-analysis. Am J Ophthalmol. 247:181–199. 2023.PubMed/NCBI View Article : Google Scholar

6 

Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B and Ang M: Refractive surgery. Lancet. 393:2085–2098. 2019.PubMed/NCBI View Article : Google Scholar

7 

Wang M, Chen Y and Zhang Y: Laser-assisted subepithelial keratomileusis substituted for an aborted small-incision lenticule extraction due to large black area formation. J Cataract Refract Surg. 46:913–917. 2020.PubMed/NCBI View Article : Google Scholar

8 

Yao L, Zhang M, Wang D, Zhao Q, Wang S and Bai H: Small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) used to treat myopia and myopic astigmatism: A systematic review and meta-analysis of randomized clinical trials. Semin Ophthalmol. 38:283–293. 2023.PubMed/NCBI View Article : Google Scholar

9 

Chiam NPY and Mehta JS: Comparing patient-reported outcomes of laser in situ keratomileusis and small-incision lenticule extraction: A review. Asia Pac J Ophthalmol (Phila). 8:377–384. 2019.PubMed/NCBI View Article : Google Scholar

10 

Wong AHY, Cheung RKY, Kua WN, Shih KC, Chan TCY and Wan KH: Dry eyes after SMILE. Asia Pac J Ophthalmol (Phila). 8:397–405. 2019.PubMed/NCBI View Article : Google Scholar

11 

Huang Q, Liu L, Ma P, Sun Y, Wang Z, Bai J and Liu T: Grading for suction loss in small incision lenticule extraction. Int Ophthalmol. 43:665–675. 2023.PubMed/NCBI View Article : Google Scholar

12 

Wan KH, Lin TPH, Lai KHW, Liu S and Lam DSC: Options and results in managing suction loss during small-incision lenticule extraction. J Cataract Refract Surg. 47:933–941. 2021.PubMed/NCBI View Article : Google Scholar

13 

Wang Y, Ma J, Zhang J, Dou R, Zhang H, Li L, Zhao W and Wei P: Incidence and management of intraoperative complications during small-incision lenticule extraction in 3004 cases. J Cataract Refract Surg. 43:796–802. 2017.PubMed/NCBI View Article : Google Scholar

14 

Krueger RR and Meister CS: A review of small incision lenticule extraction complications. Curr Opin Ophthalmol. 29:292–298. 2018.PubMed/NCBI View Article : Google Scholar

15 

Li SM, Zhan S, Li SY, Peng XX, Hu J, Law HA and Wang NL: Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia. Cochrane Database Syst Rev. 2(CD009799)2016.PubMed/NCBI View Article : Google Scholar

16 

Wilson SE: Biology of keratorefractive surgery-PRK, PTK, LASIK, SMILE, inlays and other refractive procedures. Exp Eye Res. 198(108136)2020.PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Wei L, Qi T, Li N, Shi Q, Mi S and Pei C: Management after two consecutive suction losses during small‑incision lenticule extraction: A case report. Exp Ther Med 31: 126, 2026.
APA
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., & Pei, C. (2026). Management after two consecutive suction losses during small‑incision lenticule extraction: A case report. Experimental and Therapeutic Medicine, 31, 126. https://doi.org/10.3892/etm.2026.13122
MLA
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., Pei, C."Management after two consecutive suction losses during small‑incision lenticule extraction: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 126.
Chicago
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., Pei, C."Management after two consecutive suction losses during small‑incision lenticule extraction: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 126. https://doi.org/10.3892/etm.2026.13122
Copy and paste a formatted citation
x
Spandidos Publications style
Wei L, Qi T, Li N, Shi Q, Mi S and Pei C: Management after two consecutive suction losses during small‑incision lenticule extraction: A case report. Exp Ther Med 31: 126, 2026.
APA
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., & Pei, C. (2026). Management after two consecutive suction losses during small‑incision lenticule extraction: A case report. Experimental and Therapeutic Medicine, 31, 126. https://doi.org/10.3892/etm.2026.13122
MLA
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., Pei, C."Management after two consecutive suction losses during small‑incision lenticule extraction: A case report". Experimental and Therapeutic Medicine 31.5 (2026): 126.
Chicago
Wei, L., Qi, T., Li, N., Shi, Q., Mi, S., Pei, C."Management after two consecutive suction losses during small‑incision lenticule extraction: A case report". Experimental and Therapeutic Medicine 31, no. 5 (2026): 126. https://doi.org/10.3892/etm.2026.13122
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team