Wan Kelvin H, Wang Xiao Ying, Lai Kenny H W, Alio Jorge L, Ang Marcus, Chan Colin, Chan Tommy C Y, Cheng George P M, Elsheikh Ahmed, Hjortdal Jesper, Huang Guofu, Jhanji Vishal, Mehta Jodhbir S, Rao Srinivas K, Sato Masaki, Sekundo Walter, Sharma Namrata, Shetty Rohit, Wang Yan, Xiao Yueying, Yang Yabo, Zhai Changbin, Zhang Fengju, Zhou Xingtao, Lam Dennis S C
The C-MER Dennis Lam and Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Eye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China; National Health Commission Key Laboratory of Myopia and Related Eye Diseases, Fudan University, Shanghai, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
Asia Pac J Ophthalmol (Phila). 2025 Jul-Aug;14(4):100221. doi: 10.1016/j.apjo.2025.100221. Epub 2025 Jun 28.
Small incision lenticule extraction (SMILE) surgery was developed in 2008 as an extension of the femtosecond lenticule extraction procedure. Over the years, SMILE has become a highly popular laser refractive surgery offering a minimally invasive alternative to LASIK for correcting myopia and myopic astigmatism. Despite its benefits such as a flapless femtosecond laser procedure with reduced corneal nerve disruption, the procedure's relative novelty necessitates standardization. Given the myriads of emerging information and variability, a panel of 22 international experts is formed by the Asia Pacific Myopic Society (APMS) and the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) to explore the controversy and to work out a consensus on SMILE. This consensus manuscript arises from a systematic exploration of current literature and is supported by the collective insights of international experts in the field of refractive surgery. The panel convened to review the issues, engage in discussion, develop proposals, and vote to establish consensus across four areas: 1) preoperative assessment, 2) preoperative surgical planning, 3) intraoperative considerations, and 4) postoperative management in a five-point Likert scale (strongly agree, agree, neutral, disagree and strongly disagree). Consensus was achieved when at least 75 % of the experts had voted for "strongly agree" or "agree" on the consensus statement concerned. 63 consensus statements were discussed, with 51 (81.0 %) statements reaching consensus. By establishing standardized consensus, this paper aims to reduce variability and enhance predictability and safety in refractive outcomes. Ongoing research is encouraged on issues where consensus could not be reached among the international panel of experts (IPE).
小切口透镜切除术（SMILE）手术于2008年作为飞秒透镜切除术的延伸而开发。多年来，SMILE已成为一种非常受欢迎的激光屈光手术，为矫正近视和近视散光提供了一种微创替代LASIK的方法。尽管它有诸多益处，比如无瓣飞秒激光手术且角膜神经损伤减少，但该手术相对较新，需要标准化。鉴于新出现的大量信息和变异性，亚太近视协会（APMS）和亚太眼科教授学会（AAPPO）成立了一个由22名国际专家组成的小组，以探讨争议并就SMILE达成共识。这份共识手稿源于对当前文献的系统探索，并得到了屈光手术领域国际专家的集体见解的支持。该小组召开会议审查问题、进行讨论、提出建议并投票，以在四个领域达成共识：1）术前评估，2）术前手术规划，3）术中注意事项，4）术后管理，采用五点李克特量表（强烈同意、同意、中立、不同意和强烈不同意）。当至少75%的专家对相关共识声明投票选择“强烈同意”或“同意”时，即达成共识。共讨论了63项共识声明，其中51项（81.0%）声明达成了共识。通过建立标准化共识，本文旨在减少变异性，提高屈光手术结果的可预测性和安全性。鼓励对国际专家小组（IPE）未能达成共识的问题进行持续研究。
