London Vision Clinic, London, United Kingdom; Biomedical Science Research Institute, Ulster University, Coleraine, United Kingdom; Columbia University Medical Center, New York, New York, USA; Sorbonne Université, Paris, France.
London Vision Clinic, London, United Kingdom.
J Cataract Refract Surg. 2019 Jun;45(6):872-877. doi: 10.1016/j.jcrs.2019.02.036. Epub 2019 Apr 12.
We describe a complication of false plane creation during small-incision lenticule extraction (SMILE) and the surgical plan for subsequent lenticule removal. During a primary SMILE procedure to treat high myopia, the separator instrument entered a false lamellar plane as a result of an area of resistance caused by an area of opaque bubble layer (OBL). The procedure was aborted to avoid removing an irregular lenticule. Based on measurements of the anatomic landscape, a new inferonasal small incision was created. The lenticule was separated and removed without further incidence. The patient recovered as normal and at 6 months, the uncorrected distance visual acuity was 20/16. This case highlights the importance of monitoring the bubble layer creation and interface separation to avoid creating or removing an irregular lenticule. It also shows the importance of layered corneal imaging to analyze and diagnose complications as well as of aborting a procedure and planning lenticule removal at a later time if deemed appropriate.
我们描述了在小切口微透镜提取（SMILE）过程中假平面形成的并发症，以及随后进行微透镜切除的手术方案。在一次治疗高度近视的原发性 SMILE 手术中，由于存在不透明气泡层（OBL）区域导致的阻力区域，分离器器械进入了假板层平面。为避免切除不规则的微透镜，手术被中止。根据解剖学特征的测量，在新的鼻下方创建了一个小切口。微透镜被分离并取出，没有进一步发生并发症。患者恢复正常，6 个月时，未矫正的远视力为 20/16。该病例强调了监测气泡层形成和界面分离以避免形成或切除不规则微透镜的重要性。它还表明了分层角膜成像对于分析和诊断并发症的重要性，以及在认为合适时中止手术并计划稍后进行微透镜切除的重要性。
