Liu Manli, Wang Huan, Lin Haiqin, Liu Quan
State Key Laboratory of Ophthalmology, Department of Refractive Surgery Center, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Center for Certification and Evaluation, Guangdong Food and Drug Administration, Guangzhou, China.
Cornea. 2018 Oct;37(10):1260-1263. doi: 10.1097/ICO.0000000000001691.
To identify and develop an efficient technique to separate the lenticule edge in small incision lenticule extraction (SMILE).
Four hundred eyes of 400 consecutive patients with myopia assigned to receive SMILE were included in the study. Eyes with poor-quality laser treatment were excluded, and the second eye of the same patient was included. Two skilled surgeons performed SMILE in the Zhongshan Ophthalmic Center. Each surgeon was allotted 200 patients. One surgeon used the modified technique, whereas the other surgeon used the conventional technique to identify and separate the lenticule edge. All intraoperative complications associated with lenticule edge dissection and the duration of lenticule dissection were recorded.
There were 200 eyes each in the modified technique group (group A) and the conventional technique group (group B). The mean lenticule dissection time was 49 ± 10 seconds in group A and 59 ± 43 seconds in group B (P = 0.002). Within 70 seconds, lenticule dissection was completely finished in 96.5% of eyes in group A and 86.0% in group B. Difficult lenticule dissection was experienced in 3.5% (7/200) of cases in group A and in 14.0% (28/200) of cases in group B.
The modified lenticule edge dissection technique of SMILE is simpler and faster in identifying the correct dissection plane. It is efficient in reducing surgical manipulation, shortening the learning curve required for lenticule dissection, and allows surgeons to perform SMILE more safely and efficiently.
识别并开发一种有效的技术，用于在小切口透镜切除术（SMILE）中分离透镜边缘。
本研究纳入了400例连续接受SMILE手术的近视患者的400只眼睛。排除激光治疗质量差的眼睛，同一患者的第二只眼睛被纳入。两名熟练的外科医生在中山眼科中心进行SMILE手术。每位外科医生分配200例患者。一名外科医生使用改良技术，而另一名外科医生使用传统技术来识别和分离透镜边缘。记录所有与透镜边缘解剖相关的术中并发症以及透镜解剖的持续时间。
改良技术组（A组）和传统技术组（B组）各有200只眼睛。A组透镜平均解剖时间为49±10秒，B组为59±43秒（P = 0.002）。在70秒内，A组96.5%的眼睛完成了透镜解剖，B组为86.0%。A组3.5%（7/200）的病例和B组14.0%（28/200）的病例经历了困难的透镜解剖。
SMILE改良的透镜边缘解剖技术在识别正确的解剖平面方面更简单、更快。它有效地减少了手术操作，缩短了透镜解剖所需的学习曲线，并使外科医生能够更安全、高效地进行SMILE手术。
