Ophthalmology Department, Eye & ENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
BMC Ophthalmol. 2022 Mar 8;22(1):108. doi: 10.1186/s12886-022-02333-x.
To study the impact of unintended initial dissection of the posterior plane (UIDPP) on operation time and surgical outcomes during small incision lenticule extraction (SMILE) surgery.
This was a retrospective study. Based on the SMILE procedure video, the operating eyes were assigned to the normal and UIDPP groups according to the presence or absence of UIDPP signals during surgery. The UIDPP group was further separated into early and late detection based on whether the complete dissection of the lenticule posterior plane or not. Patient's demographic data, preoperative evaluation data, operation time and postoperative outcomes were collected.
Sixty-six patients (66 eyes) who underwent SMILE were included, with 24 eyes with UIDPP (13 in the early detection group and 11 in the late group). The optical zone was smaller (median 6.5 vs. 6.6, P = 0.007), and the operation time was longer (median, 189.5 vs. 91.0 s, P < 0.001) in the UIDPP group compared with normal group. There were significant differences in operation time between the late detection group and early detection group (median, 489.0 vs. 139.0 s, P < 0.05) and between the late detection group and normal group (median 489.0 vs. 91.0 s, P < 0.05), while the optical zone was different only between the late detection and normal groups (median, 6.5 vs. 6.6, P < 0.05). At the one-year follow-up, UDVA was better than or equal to 20/20 in 87.5% of eyes, and 75% of eyes were within ± 0.5 D of the intended refractive target. One eye lost one Snellen line.
The occurrence of UIDPP will significantly prolong the operation time, but not affect the recovery of long-term visual acuity after surgery. Detecting UIDPP earlier could help shorten the operation time.
研究小切口透镜切除术（SMILE）手术中无意初始后平面分离（UIDPP）对手术时间和手术结果的影响。
这是一项回顾性研究。根据 SMILE 手术视频，根据手术过程中是否存在 UIDPP 信号，将手术眼分为正常组和 UIDPP 组。根据是否完整分离透镜后平面，将 UIDPP 组进一步分为早期和晚期检测。收集患者的人口统计学数据、术前评估数据、手术时间和术后结果。
66 例（66 只眼）接受 SMILE 手术，其中 24 只眼发生 UIDPP（早期检测组 13 只眼，晚期组 11 只眼）。与正常组相比，UIDPP 组的光学区较小（中位数 6.5 比 6.6，P=0.007），手术时间较长（中位数 189.5 比 91.0 s，P<0.001）。晚期检测组与早期检测组、晚期检测组与正常组的手术时间差异均有统计学意义（中位数 489.0 比 139.0 s，P<0.05），而晚期检测组与正常组的光学区差异仅具有统计学意义（中位数 6.5 比 6.6，P<0.05）。术后 1 年随访时，87.5%的眼最佳矫正视力（UDVA）≥20/20，75%的眼屈光度在预期目标值的±0.5 D 以内。1 只眼视力丧失 1 行。
UIDPP 的发生会显著延长手术时间，但不会影响术后长期视力的恢复。尽早发现 UIDPP 有助于缩短手术时间。
