Sedky Ahmed N, Wahba Sherine S, Roshdy Maged M, Ayaad Nermeen R
Eye Subspecialty Center, Cairo, Egypt, 18 Elkhalifa Elmamoun Street, Heliopolis, Cairo, Egypt.
Ain Shams University, Al Watany Eye Hospital and Watany Research and Development Center (WRDC), Cairo, Egypt.
BMC Ophthalmol. 2018 Feb 17;18(1):49. doi: 10.1186/s12886-018-0712-7.
Different enhancement procedures have been suggested for reduction of residual refractive errors after SMILE. The aim of this study is to evaluate an improved cap-preserving technique for enhancement after SMILE (Re-SMILE).
A retrospective case series was conducted at Eye subspecialty center, Cairo, Egypt on 9 eyes with myopia or myopic astigmatism (spherical equivalent - 8.0 and - 12.0D). undergoing SMILE procedure and needed second interference. This was either because the more myopic meridian was more than - 10.0 D and therefore planned to have two-steps procedure (six eyes) or because of under correction needing enhancement (three eyes). Assessment after the primary SMILE procedure was conducted at 1 day, 1 week, 1 month and 3 months postoperatively. Assessment after Re-SMILE was conducted at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. The assessments included full ophthalmic examination, objective and subjective refraction, and rotating Scheimpflug camera imaging.
Preoperatively, the mean refractive spherical equivalent (MRSE) values were: - 9.36 ± 0. 89. After primary SMILE it was - 2.18 ± 0.71. After Re-SMILE it was - 0.13 ± 0.68. MRSE was significantly improved after both procedures (P < 0.01). The safety index of primary SMILE cases was 1.65 ± 0.62 and for Re-SMILE 1.13 ± 0.34 and the efficacy index was 1.14 ± 0.24 after primary SMILE and 1.11 ± 0.26 after Re-SMILE.
Centered cap-preserving Re-SMILE is an effective procedure in reducing residual refractive errors after primary SMILE in high myopes.
已提出不同的增强手术方法以减少全飞秒激光微小切口基质透镜切除术（SMILE）后的残余屈光不正。本研究的目的是评估一种改良的保留角膜帽技术用于SMILE术后增强手术（Re-SMILE）。
在埃及开罗的眼科亚专业中心进行了一项回顾性病例系列研究，研究对象为9只患有近视或近视散光（等效球镜度数为-8.0至-12.0D）的眼睛，这些眼睛接受了SMILE手术且需要二次干预。这要么是因为更高度数的子午线超过-10.0D，因此计划进行两步手术（6只眼），要么是因为矫正不足需要增强手术（3只眼）。在初次SMILE手术后1天、1周、1个月和3个月进行评估。在Re-SMILE手术后1天、1周、1个月、3个月、6个月和1年进行评估。评估包括全面的眼科检查、客观和主观验光以及旋转式Scheimpflug相机成像。
术前，平均屈光等效球镜（MRSE）值为：-9.36±0.89。初次SMILE术后为-2.18±0.71。Re-SMILE术后为-0.13±0.68。两种手术后MRSE均有显著改善（P<0.01）。初次SMILE病例的安全指数为1.65±0.62，Re-SMILE病例为1.13±0.34，初次SMILE术后的疗效指数为1.14±0.24，Re-SMILE术后为1.11±0.26。
中心保留角膜帽的Re-SMILE是一种有效减少高度近视患者初次SMILE术后残余屈光不正的手术。
