Department of Ophthalmology, The University of Hong Kong, Cyberport, Hong Kong.
Hong Kong Laser Eye Center, Hong Kong, Hong Kong.
Br J Ophthalmol. 2018 Aug;102(8):1122-1126. doi: 10.1136/bjophthalmol-2017-310993. Epub 2017 Nov 9.
We described a modified 'hydroexpression' technique for the lenticule removal during small-incision lenticule extraction (SMILE) surgery and compared the results with conventional forceps method.
This was a retrospective, comparative study of 50 patients who underwent SMILE surgery by the same surgeon. We compared the 1-week and 3-months postoperative results after SMILE using the hydroexpression technique with the conventional forceps technique. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive accuracy, safety index and efficacy index.
The baseline characteristics were comparable between both groups. At postoperative 1 week, the safety index in forceps and hydroexpression group was 0.93±0.11 and 0.97±0.10, respectively (P=0.246). At 3 months, they were 1.00±0.06 and 0.99±0.09 (P=0.850). For efficacy indices, at 1 week they were 0.84±0.17 and 0.91±0.17 (P=0.158). At 3 months, they were 0.92±0.13 and 0.94±0.19 (P=0.624). All eyes aimed for a plano target. 96% in forceps group and 90% in hydroexpression group were within ±0.50 dioptre (D) in spherical equivalent refraction (SEQ) correction at postoperative 3 months (P=0.567). The mean errors of SEQ correction were -0.10±0.21 D in forceps group and -0.08±0.30 D in hydroexpression group (P=0.705).
Hydroexpression was simple and safe and had early results comparable to the conventional forceps technique. This technique was particularly useful for cases with more adhesions between lenticule and anterior cap, thin lenticule cases and for the inexperienced SMILE surgeons.
我们描述了一种改良的“水动力分离”技术，用于小切口角膜基质透镜切除术（SMILE）手术中透镜的移除，并将结果与传统的镊夹法进行比较。
这是一项回顾性、比较性研究，纳入了由同一位外科医生进行 SMILE 手术的 50 名患者。我们比较了使用水动力分离技术和传统镊夹技术的 SMILE 术后 1 周和 3 个月的结果。主要观察指标包括未矫正的远视力、矫正的远视力、屈光准确性、安全性指数和有效性指数。
两组患者的基线特征具有可比性。术后 1 周时，镊夹组和水动力分离组的安全性指数分别为 0.93±0.11 和 0.97±0.10（P=0.246）。术后 3 个月时，分别为 1.00±0.06 和 0.99±0.09（P=0.850）。对于有效性指数，术后 1 周时，分别为 0.84±0.17 和 0.91±0.17（P=0.158）。术后 3 个月时，分别为 0.92±0.13 和 0.94±0.19（P=0.624）。所有患者的目标均为正视。术后 3 个月时，镊夹组 96%和水动力分离组 90%的患者等效球镜（SEQ）屈光度在±0.50 屈光度（D）以内（P=0.567）。镊夹组 SEQ 矫正的平均误差为-0.10±0.21 D，水动力分离组为-0.08±0.30 D（P=0.705）。
水动力分离技术简单、安全，早期结果与传统镊夹法相当。对于透镜与前囊之间粘连较多、透镜较薄以及经验不足的 SMILE 外科医生，该技术特别有用。
