PDF(Pubmed)
Abstract：
OBJECTIVE: To describe three patterns of posterior plane edge identification in small-incision lenticule extraction and to prevent lenticule mis-dissection.
METHODS: Femtosecond laser application was performed for small-incision lenticule extraction (SMILE) by one surgeon. The surgical videos of SMILE were recorded and re-watched by the surgeon after operation.
RESULTS: Small-incision lenticule extraction was performed in 52 eyes of 28 patients, and no patient had cap-lenticular adhesion. Three patterns of posterior plane of lenticule were noticed when the surgical videos were re-watched. A \"double lines\" attached to the dissector were visible, signifying the reflective tape of the edge of the lenticule and the cap. During the expansion of the posterior lamellar separation, a fusiform opening between the lenticule edge and the underlying matrix layer was assumed to be a \"leaf sign.\" With some unintentional operation, the posterior lamella was pushed away from the surgeon. The edge of the lenticule away from the anatomical part, the marking of the femtosecond laser cut, and the edge of the cap layer showed three reflective bands, which formed a \"triple lines.\" The \"double lines,\" \"leaf sign,\" and \"triple lines\" were observed in 30 eyes (57.7%), 21 eyes (40.4%), and 1 eye (1.9%), respectively.
CONCLUSIONS: These three signs cover possible situations and provide visual landmarks to identify the correct dissection of the posterior plane, which can help shorten the learning curve of novice doctors.
METHODS: Femtosecond laser application was performed for small-incision lenticule extraction (SMILE) by one surgeon. The surgical videos of SMILE were recorded and re-watched by the surgeon after operation.
RESULTS: Small-incision lenticule extraction was performed in 52 eyes of 28 patients, and no patient had cap-lenticular adhesion. Three patterns of posterior plane of lenticule were noticed when the surgical videos were re-watched. A \"double lines\" attached to the dissector were visible, signifying the reflective tape of the edge of the lenticule and the cap. During the expansion of the posterior lamellar separation, a fusiform opening between the lenticule edge and the underlying matrix layer was assumed to be a \"leaf sign.\" With some unintentional operation, the posterior lamella was pushed away from the surgeon. The edge of the lenticule away from the anatomical part, the marking of the femtosecond laser cut, and the edge of the cap layer showed three reflective bands, which formed a \"triple lines.\" The \"double lines,\" \"leaf sign,\" and \"triple lines\" were observed in 30 eyes (57.7%), 21 eyes (40.4%), and 1 eye (1.9%), respectively.
CONCLUSIONS: These three signs cover possible situations and provide visual landmarks to identify the correct dissection of the posterior plane, which can help shorten the learning curve of novice doctors.
摘要：
目的：描述小切口微透镜取出后平面边缘识别的三种模式，以防止微透镜错位。
方法：一名外科医生应用飞秒激光进行小切口微透镜提取（SMILE）。手术后由外科医生记录并重新观看SMILE的手术视频。
结果：28例52眼进行了小切口微透镜摘除，没有患者出现帽状透镜粘连。当重新观看手术视频时，注意到微透镜的后平面的三种模式。解剖器附带的“双线”可见，表示透镜边缘和帽的反光带。在后板层分离的扩张过程中，微透镜边缘和下面的基质层之间的梭形开口被认为是“叶子”符号。\"有了一些无意的操作，后层被推离外科医生。微透镜远离解剖部分的边缘，飞秒激光切割的标记，盖层的边缘显示出三个反射带，形成了一条“三重线”。\"The\"双线,\"\"叶子标志,在30只眼睛中观察到“”和“三行”（57.7％），21只眼（40.4%），和1只眼睛(1.9%)，分别。
结论：这三个标志涵盖了可能的情况，并提供了视觉标志，以识别后平面的正确解剖，这可以帮助缩短新手医生的学习曲线。
方法：一名外科医生应用飞秒激光进行小切口微透镜提取（SMILE）。手术后由外科医生记录并重新观看SMILE的手术视频。
结果：28例52眼进行了小切口微透镜摘除，没有患者出现帽状透镜粘连。当重新观看手术视频时，注意到微透镜的后平面的三种模式。解剖器附带的“双线”可见，表示透镜边缘和帽的反光带。在后板层分离的扩张过程中，微透镜边缘和下面的基质层之间的梭形开口被认为是“叶子”符号。\"有了一些无意的操作，后层被推离外科医生。微透镜远离解剖部分的边缘，飞秒激光切割的标记，盖层的边缘显示出三个反射带，形成了一条“三重线”。\"The\"双线,\"\"叶子标志,在30只眼睛中观察到“”和“三行”（57.7％），21只眼（40.4%），和1只眼睛(1.9%)，分别。
结论：这三个标志涵盖了可能的情况，并提供了视觉标志，以识别后平面的正确解剖，这可以帮助缩短新手医生的学习曲线。
