Uma Eye Clinic, Chennai, Tamil Nadu, , India.
Indian J Ophthalmol. 2023 Feb;71(2):476-480. doi: 10.4103/ijo.IJO_1757_22.
To determine the safety and efficacy of low-energy settings in small incision lenticule extraction (SMILE) for correcting myopia and myopic astigmatism.
We included patients aged ≥18 years with the myopia of -0.5 to -10 D and myopic astigmatism of -0.5 to -5 Dcyl in this retrospective case series performed at a private eye hospital in South India. All patients had preoperative best-corrected visual acuity of LogMar 0.0 ± 0, with stable refraction for 1 year and normal corneal topography. Ocular surface disease and other pathology cases were excluded. The repetition rate of the laser was 500 kHz, and the pulse energy was 110 nJ. The lenticule diameter was set at 6.5 mm, cap diameter was 7.20 mm, and intended cap thickness was 110-130 μ. The spot distance was 4.5 μm. All patients were evaluated immediately postoperation and on postoperative days 1, 8, and 30.
Overall, 541 eyes were included. The mean patient age was 25.03 ± 4.1 years. The mean spherical error was -3.76 ± 1.84 Ds. The mean cylinder was -1.24 ± 0.91. The mean spherical equivalent of refraction was -4.22 ±1.94 D. The logMAR on postoperative day 1 was 0.0 ± 0. The mean spherical equivalent at 1 month was 0.28 ± 1.06 D. There was no loss of Snellen's lines after the procedure. The mean spherical equivalent of refraction to the target was 95% within ± 0.50 D. The postoperative astigmatism was within 0.5 Dycl. No intraoperative complications of SMILE including retained lenticule fragments, tears of incision, or improper dissection occurred.
Low-energy settings in SMILE are safe and effective in correcting myopia and myopic astigmatism including high cylinders (>3 Dcyl).
确定小切口微透镜提取术（SMILE）中低能量设置矫正近视和近视散光的安全性和有效性。
本回顾性病例系列研究在印度南部的一家私立眼科医院进行，纳入了年龄≥18 岁、近视 -0.5 至-10 D，近视散光 -0.5 至-5 Dcyl 的患者。所有患者术前最佳矫正视力均为 LogMar 0.0±0，屈光度稳定 1 年，角膜地形正常。排除眼表面疾病和其他病理学病例。激光重复率为 500 kHz，脉冲能量为 110 nJ。透镜直径设定为 6.5 mm，帽直径为 7.20 mm，预期帽厚度为 110-130 μ。光斑距离为 4.5 μm。所有患者均在术后即刻以及术后第 1、8 和 30 天进行评估。
共纳入 541 只眼。患者平均年龄为 25.03±4.1 岁。平均球镜误差为-3.76±1.84 Ds。平均柱镜为-1.24±0.91。平均等效球镜屈光度为-4.22±1.94 D。术后第 1 天 logMAR 为 0.0±0。术后 1 个月平均等效球镜为 0.28±1.06 D。术后均未损失 Snellen 视力线。术后 95%的患者屈光度达到目标值，相差在±0.50 D 以内。术后散光在 0.5 Dycl 以内。SMILE 术中无透镜碎片残留、切口撕裂或不当分离等并发症发生。
SMILE 中的低能量设置在矫正近视和近视散光（包括高柱镜度数>3 Dcyl）方面是安全有效的。
