title: Refractive Lenticule Extraction Complications.
abstract: OBJECTIVE
  To report the complications associated with refractive lenticule extraction (ReLEx) in its 2 modalities: femtosecond lenticule extraction (FLEx) and small incision lenticule extraction (SMILE).
  
  
  METHODS
  In this retrospective review of a consecutive clinical case series, all patients who had a complicated ReLex FLEx or ReLEx SMILE procedure at the Cornea and External Disease Department at the Instituto de Oftalmologia Fundacion Conde de Valenciana, Mexico City, Mexico, were included. Demographic characteristics, type of complication, and final refraction and visual outcomes were recorded.
  
  
  RESULTS
  Our study comprised 94 eyes in the FLEx group and 160 eyes in the SMILE group with a mean follow-up period of 36 months. In the FLEx group, 15 eyes (18.3%) presented surgery-related complications, including suction loss, black spots, bubbles in the interface, and lenticule misdissection. In the SMILE group, 43 eyes (26.9%) had complications, including an epithelial defect (the most frequent), suction loss, opaque bubble layer, cap rupture, and lenticule rupture.
  
  
  CONCLUSIONS
  Although ReLEx complications can occur, most of them are related to inexperience and have a favorable resolution with no lasting effect on the patient's final visual acuity.
authors.affiliation: Department of Cornea and Refractive Surgery, Instituto de Oftalmologia "Conde de Valenciana," Mexico City, Mexico.
authors.forename: Arturo
authors.initials: A
authors.lastname: Ramirez-Miranda
authors.forename: Tito
authors.initials: T
authors.lastname: Ramirez-Luquin
authors.forename: Alejandro
authors.initials: A
authors.lastname: Navas
authors.forename: Enrique O
authors.initials: EO
authors.lastname: Graue-Hernandez
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000009:adverse effects* / Q000379:methods; D019781:Corneal Topography; D006801:Humans; D007431:Intraoperative Complications; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology