Liu Yu-Chi, Pujara Tarak, Mehta Jodhbir S
Singapore Eye Research Institute, Singapore, Singapore; Singapore National Eye Centre, Singapore, Singapore.
Carl Zeiss Meditec AG, Singapore, Singapore.
PLoS One. 2014 Dec 1;9(12):e113774. doi: 10.1371/journal.pone.0113774. eCollection 2014.
Small incision lenticule extraction (SMILE) is an alternative to Laser-Assisted in situ Keratomileusis (LASIK) for correction of myopia. In cases where surgeons inadvertently dissect the posterior surface first, identification of the anterior surface and subsequent removal become difficult since the anterior surface of the lenticule is compacted against the anterior stromal surface. This may result in incomplete lenticule removal, and a remnant of intrastromal lenticule in SMILE may lead to visual sequelae. In order to aid surgeons in lenticule removal, we have designed and developed 5 novel SMILE lenticule strippers to locate and extract the lenticules more easily. The aim of this study was to investigate and compare the efficacy and quality of these lenticule strippers in assisting SMILE. Thirty porcine eyes were used. The ease of extraction and removal of the lenticule with different strippers was graded by an experienced SMILE surgeon, the extracted lenticule circularity was evaluated by calculating the lenticule circularity, and the intactness of the extracted lenticule edge was assessed using scanning electron microscopy. We found these novel strippers can be of great help to improve the safety and quality of SMILE surgery, particularly in those cases of difficult lenticule extraction.
微小切口基质透镜切除术（SMILE）是一种用于矫正近视的准分子原位角膜磨镶术（LASIK）替代方法。在手术过程中，如果外科医生不小心先切开了透镜的后表面，由于透镜的前表面被挤压在前基质表面上，识别前表面并随后取出透镜就会变得困难。这可能导致透镜取出不完全，而SMILE手术中基质内透镜残留可能会导致视觉后遗症。为了帮助外科医生取出透镜，我们设计并开发了5种新型SMILE透镜剥离器，以便更轻松地定位和取出透镜。本研究的目的是调查和比较这些透镜剥离器在辅助SMILE手术中的疗效和质量。使用了30只猪眼。由一位经验丰富的SMILE外科医生对使用不同剥离器取出透镜的难易程度进行评分，通过计算透镜圆度来评估取出透镜的圆度，并使用扫描电子显微镜评估取出透镜边缘的完整性。我们发现这些新型剥离器对提高SMILE手术的安全性和质量有很大帮助，特别是在那些透镜取出困难的病例中。
