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Controversies, consensuses and guidelines on Small Incision Lenticule Extraction (SMILE) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Myopia Society (APMS)

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机构: [1]The C-MER Dennis Lam and Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [2]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China [3]Eye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China [4]National Health Commission Key Laboratory of Myopia and Related Eye Diseases, Fudan University, Shanghai, China [5]Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China [6]Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China [7]Vissum Miranza, Alicante, Spain [8]Miguel Hernandez University, Alicante, Spain [9]Singapore National Eye Centre, Singapore, Singapore [10]Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore [11]Singapore Eye Research Institute, Singapore, Singapore [12]University of Canberra, Faculty of Health, ACT, Australia [13]Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong, China [14]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China [15]Hong Kong Laser Eye Center, Hong Kong, China [16]Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision, and Brain Health), Wenzhou, China [17]School of Engineering, University of Liverpool, Liverpool, UK [18]National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK [19]Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark [20]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China [21]Vision Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, PA, US [22]Darshan Eye Care & Surgical Centre, Chennai, India [23]Department of Ophthalmology, Sato Eye Clinic, Iias Tsukuba Medical Court, Sato Eye Clinic 5-19 Kenkyugakuen, Tsukuba, Ibaraki, Japan [24]Department of Ophthalmology, University Hospital Marburg (UKGM), Philipps University of Marburg, Germany [25]Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India [26]Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India [27]The Primasia International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China [28]Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China [29]Eye Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China [30]Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China [31]Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China [32]Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China [33]University of Sydney, Faculty of Medicine, NSW, Australia
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关键词: Consensus Small incision lenticule extraction SMILE APMS AAPPO

摘要:
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).Copyright © 2025. Published by Elsevier Inc.

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出版当年[2025]版:
大类 | 2 区 医学
小类 | 2 区 眼科学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 眼科学
第一作者:
第一作者机构: [1]The C-MER Dennis Lam and Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [2]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
通讯作者:
通讯机构: [1]The C-MER Dennis Lam and Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China [2]Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China [3]Eye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China [4]National Health Commission Key Laboratory of Myopia and Related Eye Diseases, Fudan University, Shanghai, China [5]Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China [6]Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China [28]Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China [31]Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China [32]Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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