飞秒激光小切口角膜基质透镜取出术的并发症

Complications of small incision lenticule extraction(SMILE)

目的:分析飞秒激光小切口角膜基质透镜取出术(SMILE)术中并发症及其处理。方法:回顾性病例研究。郑州大学第一附属医院2018年7月1日至2019年6月28日进行的SMILE手术者700例(1390眼),分析术中的并发症及处理。结果:其中,1387眼顺利完成手术,仅3眼改行飞秒激光LASIK手术。术中有57眼发生并发症,包括负压脱失4眼,不透明气泡层13眼,黑斑9眼,边缘切口撕裂6眼,角膜基质透镜撕裂或组织残留4眼,角膜基质透镜分离取出困难6眼以及其他并发症15眼。这些术中并发症均得到适当的处理,术后3个月的裸眼视力均达到术前最佳矫正视力水平。结论:SMILE手术存在一定比例的术中并发症,可能影响视力的恢复,但术中及时正确的处理可使最终视力不受影响。

Objective To analyze the intraoperative complications and their management of small incision lenticule extraction(SMILE).Methods A retrospective case study.A total of 1390 eyes of 700 patients underwent SMILE from Jul.1st 2018 to Jun.28th 2019 in First Affiliated Hospital of Zhengzhou University.The complications and treatment during the operation were analyzed.Results Among 1390 eyes of 700 cases,the operations successfully completed in 1387 eyes and only 3 eyes were converted to femtosecond laser LASIK.Complications occurred in 57 eyes during the operation,included 4 eyes with suction loss,13 eyes with opaque bubble layer,9 eyes with dark spots,6 eyes with laceration of side incisions,4 eyes with corneal stroma lens tear or tissue residue,6 eyes with difficulty in separating and removing the corneal stroma lens and other complications in 15 eyes.These intraoperative complications were properly managed,and the uncorrected visual acuity at 3 months after surgery reached the level of the best corrected visual acuity before surgery.Conclusion There is a certain proportion of intraoperative complications in SMILE surgery,which can affect the recovery of visual acuity,but timely and proper treatment during surgery can keep the final vision unaffected.