Lischke Roman, Sekundo Walter, Wiltfang Rainer, Bechmann Martin, Kreutzer Thomas C, Priglinger Siegfried G, Dirisamer Martin, Luft Nikolaus
Department of Ophthalmology, University Hospital, Ludwig-Maximilians-University, 80337 Munich, Germany.
SMILE Eyes Clinic, Department of Ophthalmology, Philipps University, 35043 Marburg, Germany.
J Clin Med. 2022 Jul 29;11(15):4418. doi: 10.3390/jcm11154418.
Small incision lenticule extraction (SMILE), with over 5 million procedures globally performed, will challenge ophthalmologists in the foreseeable future with accurate intraocular lens power calculations in an ageing population. After more than one decade since the introduction of SMILE, only one case report of cataract surgery with IOL implantation after SMILE is present in the peer-reviewed literature. Hence, the scope of the present multicenter study was to compare the IOL power calculation accuracy in post-SMILE eyes between ray tracing and a range of empirically optimized formulae available in the ASCRS post-keratorefractive surgery IOL power online calculator. In our study of 11 post-SMILE eyes undergoing cataract surgery, ray tracing showed the smallest mean absolute error (0.40 D) and yielded the largest percentage of eyes within ±0.50/±1.00 D (82/91%). The next best conventional formula was the Potvin-Hill formula with a mean absolute error of 0.66 D and an ±0.50/±1.00 D accuracy of 45 and 73%, respectively. Analyzing this first cohort of post-SMILE eyes undergoing cataract surgery and IOL implantation, ray tracing showed superior predictability in IOL power calculation over empirically optimized IOL power calculation formulae that were originally intended for use after Excimer-based keratorefractive procedures.
小切口飞秒透镜切除术（SMILE）在全球已实施超过500万例手术，在可预见的未来，随着人口老龄化，准确计算人工晶状体度数将给眼科医生带来挑战。自SMILE引入十多年来，同行评审文献中仅有一篇关于SMILE术后白内障手术联合人工晶状体植入的病例报告。因此，本多中心研究的目的是比较光线追踪法与美国白内障与屈光手术学会（ASCRS）角膜屈光手术后人工晶状体度数在线计算器中一系列经验优化公式在SMILE术后眼内人工晶状体度数计算的准确性。在我们对11只接受白内障手术的SMILE术后眼的研究中，光线追踪法显示平均绝对误差最小（0.40 D），且在±0.50/±1.00 D范围内的眼睛比例最高（82/91%）。次优的传统公式是Potvin-Hill公式，平均绝对误差为0.66 D，±0.50/±1.00 D的准确率分别为45%和73%。分析这首批接受白内障手术和人工晶状体植入的SMILE术后眼，与最初用于准分子激光角膜屈光手术术后的经验优化人工晶状体度数计算公式相比，光线追踪法在人工晶状体度数计算方面显示出更高的可预测性。
