Zhu Jun, Li Fen-Fen, Dai Qi, Cheng Dan, Bao Fang-Jun, Yang Shih-Mo, Ye Yu-Feng
School of Ophthalmology and Optometry, The Eye Hospital of Wenzhou Medical University, 618 East Fengqi Road, Hangzhou, 310000, Zhejiang, China.
School of Mechatronic Engineering and Automation of Shanghai University, No.99 Shangda Road, Shanghai, 200444, China.
Ophthalmol Ther. 2023 Feb;12(1):365-376. doi: 10.1007/s40123-022-00612-w. Epub 2022 Nov 19.
This study aimed to evaluate the lenticule integrity and refractive outcomes of a new technique, Ye's swing technique, during small-incision lenticule extraction (SMILE).
This prospective study enrolled patients who underwent the SMILE procedure using a modified technique for lenticule dissection. Per the standard SMILE procedure, the cap cut was opened using a hook, and an anterior dissection was performed with a counterclockwise swing, from 8 to 12 o'clock. A posterior dissection was then performed by swinging counterclockwise, leaving a thin band of the peripheral rim undissected, from 8 to 4 o'clock. The counterclockwise swing was continued to separate the edges of the rim from 4 to 12 o'clock, after which microforceps were used to extract the lenticules. The primary outcome measures were safety and lenticule integrity at the end of the surgery, and the secondary outcome measure was efficacy. Changes in the ocular parameters from the preoperative visit to 1 month postoperative, including uncorrected and corrected distance visual acuity, manifest refraction, lenticule quality, and lenticule residual, were assessed using optical coherence tomography.
A total of 246 patients (490 eyes) with myopia and myopic astigmatism were included in the present study. The dissected lenticules ranged in size from 52 to 148 µm. Postoperatively, the lenticule was completely and successfully extracted in all cases. There was no incisional edge tearing during lenticule separation.
Ye's swing technique is a safe and effective procedure for lenticule dissection and refractive outcomes. We have now adopted this technique as our routine method for performing the SMILE procedure.
本研究旨在评估一种新技术——叶氏摆动技术在小切口透镜切除术（SMILE）中的透镜完整性和屈光效果。
本前瞻性研究纳入了采用改良透镜分离技术接受SMILE手术的患者。按照标准的SMILE手术流程，用钩子打开帽状切口，从8点至12点逆时针摆动进行前房分离。然后从8点至4点逆时针摆动进行后房分离，留下一小条周边边缘未分离。继续逆时针摆动从4点至12点分离边缘，之后用微型镊子取出透镜。主要观察指标为手术结束时的安全性和透镜完整性，次要观察指标为有效性。使用光学相干断层扫描评估从术前到术后1个月眼部参数的变化，包括未矫正和矫正远视力、显验光、透镜质量和透镜残留情况。
本研究共纳入246例近视和近视散光患者（490只眼）。分离的透镜大小在52至148微米之间。术后，所有病例的透镜均被完整且成功地取出。在透镜分离过程中没有切口边缘撕裂的情况。
叶氏摆动技术是一种用于透镜分离和屈光效果的安全有效的手术方法。我们现在已将该技术作为我们进行SMILE手术的常规方法。
