Objective::To study and analyze the postoperative complications of small incision lenticule extraction (SMILE).Methods::In this retrospective case series study, 4 386 patients (8 600 eyes) with complete SMILE surgical correction data in Jinan Aier Eye Hospital from March 2015 to October 2019 were selected. During and after the operation, the occurrence of complications was analyzed, and a questionnaire survey was conducted. Visual quality was assessed based on the questionnaire survey.Results::Intraoperative complications were observed in 244 eyes (2.84%), including 12 eyes (0.14%) with negative pressure suction ring loss, 154 eyes (1.80%) with an opaque bubble layer (OBL), 25 eyes (0.29%) with microincision hemorrhage, 1 eye (0.01%) with difficulty in finding the corneal matrix lens, and 33 eyes (0.38%) with unplanned lens separation. In addition, there was lens residue in 4 eyes (0.04%), incision tear in 13 eyes (0.15%), and a scanned black area in 2 eyes (0.02%). Postoperative complications were observed in 17 eyes (0.20%), including diffuse lamellar keratitis in the early postoperative period (0.09%), immune keratitis in the middle postoperative period (0.10%), and no intercorneal bacterial infection in any eyes. Three months after surgery, 26 eyes (0.30%) were overcorrected >0.75 D and 1 eye (0.01%) was undercorrected >0.75 D. One eye (0.01%) needed to undergo a second augmentation operation. Postoperative visual quality abnormalities were mainly fog, glare, and halo in the initial postoperative period, which significantly improved over time. At 6 months after surgery, 99.30% of patients were very satisfied as noted in the comprehensive evaluation of the operation.Conclusions::SMILE surgery has few complications in the treatment of myopia, and there was no serious complication affecting vision in this study. SMILE surgery is safe and effective, and patient satisfaction is high.

Objective To investigate the efficient treatment of cornea flap folds and striae after laser in situ keratomileusis (LASIK).To review the management and results of cases with severe flap wrinkling or dislodgment after LASIK.Methods Eleven patients with cornea flap folds and striae after LASIK are described.To make retrospective analysis of etiology and treatment in 11 cases who had cornea flap folds and striae after LASIK.Surgical repositioning of the flap was performed in all cases.Under the operating microscope the flap was refloated and hydrated with sterile deionized water for 2 minutes without stretching or ironing the flap.A bandage contact lens was then applied for 24 hours.Flap status,refractive changes,and final uncorrected and best corrected visual acuities were used to evaluate the outcome of flap repositioning.Results Relocation flap and bandage contact lens were used in such cases.Scraping epithelial and hydrating the cornea flap with sterile deionized water were used under operation.Twenty-four hours after treatment with sterile deionized water and a bandage contact lens,the cornea was smooth and wrinkle free.All patients who received those treatments had regalned the best-uncorrected visual acuity.Cornea was clear and had no obvious folds and striae.The flap had perfect location and no epithelial cell ingrowth.Conclusion Flap dislodgment and wrinkling are serious postoperative complications of LASIK.Early recognition of these complications and prompt surgical management are crucial to achieve a successful surgical and visual outcome.Relocation flap、hydration the cornea flap with sterile deionized water and a bandage contact lens may be a safe and efficient choice in such cases.