Om Parkash Tushya, Om Parkash Rohit, Om Parkash Sehar
Department of Refractive Surgery, Dr Om Parkash Eye Institute, Amritsar, India.
Clin Ophthalmol. 2024 Dec 12;18:3709-3712. doi: 10.2147/OPTH.S503088. eCollection 2024.
To describe the "Ridge Sign" as a conclusive indicator for differentiating the anterior and posterior lenticular planes in Small Incision Lenticule Extraction (SMILE).
Femtosecond laser application for SMILE was performed. Anterior and posterior planes were dissected. "Ridge sign" was elucidated prior to proceeding with the final dissection of the anterior plane. Our sign helps to identify anterior and posterior lenticular planes in SMILE. This sign describes a lenticular ridge noted at the junction between the dissected and undissected halves of both planes. This ridge is formed as the lenticule is attached to the cap on one side and to the stromal bed on the other side. Here, the cap is lifted with the blunt dissector's arm at the junction of the anterior and posterior dissected planes prior to the final dissection of the anterior plane. This maneuver enhances the visibility of the ridge sign and confirms correct initial anterior plane dissection, thereby preventing inadvertent cap lenticular adhesion.
In our study, 400 eyes undergoing SMILE procedures using the VisuMax femtosecond laser were included. In 96% of cases, the cap interface was separated first with ridge sign observed in all. In 4% of cases with wrong initial separation of the lenticule interface, the ridge sign was absent. Successful lenticule extraction was achieved in 100% of cases.
This confirmatory sign helps to dissect the anterior plane ahead of the posterior plane, thereby ensuring smooth lenticule extraction and preventing inadvertent cap lenticular adhesion, lenticule tears, or partial lenticular dissection.
描述“嵴征”作为小切口透镜切除术（SMILE）中区分晶状体前后平面的决定性指标。
进行用于SMILE的飞秒激光手术。分离前后平面。在进行前平面的最终分离之前阐明“嵴征”。我们的征象有助于在SMILE中识别晶状体的前后平面。该征象描述了在两个平面的已分离和未分离部分的交界处所观察到的晶状体嵴。此嵴的形成是因为透镜在一侧附着于帽，而在另一侧附着于基质床。在此，在前平面的最终分离之前，在前后分离平面的交界处用钝性分离器的臂提起帽。这一操作增强了嵴征的可视性，并确认了正确的初始前平面分离，从而防止意外的帽晶状体粘连。
在我们的研究中，纳入了400只使用VisuMax飞秒激光进行SMILE手术的眼睛。在96%的病例中，首先分离帽界面，所有病例均观察到嵴征。在4%晶状体界面初始分离错误的病例中，未观察到嵴征。所有病例均成功取出晶状体。
这一确认性征象有助于在分离后平面之前先分离前平面，从而确保晶状体顺利取出，并防止意外的帽晶状体粘连、晶状体撕裂或部分晶状体分离。
