瞳孔区同心圆离心角膜层间气泡挤压法在飞秒激光小切口角膜基质透镜取出手术中安全性有效性的研究

注册号:

Registration number:

ChiCTR2600120826 

最近更新日期:

Date of Last Refreshed on:

2026-03-20 09:00:55 

注册时间:

Date of Registration:

2026-03-20 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

瞳孔区同心圆离心角膜层间气泡挤压法在飞秒激光小切口角膜基质透镜取出手术中安全性有效性的研究

Public title:

A Study on the Safety and Efficacy of the Concentric Circles and Centripetal-Centrifugal Corneal Layer Bubble Compression Method in Femtosecond Laser Small-Incision Stromal Lens Extraction Surgery

注册题目简写:

English Acronym:

研究课题的正式科学名称:

瞳孔区同心圆离心角膜层间气泡挤压法在飞秒激光小切口角膜基质透镜取出手术中安全性有效性的研究

Scientific title:

A Study on the Safety and Efficacy of the Concentric Circles and Centripetal-Centrifugal Corneal Layer Bubble Compression Method in Femtosecond Laser Small-Incision Stromal Lens Extraction Surgery

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

陈瑞博 

研究负责人:

陈兵 

Applicant:

Ruibo Chen 

Study leader:

Bing Chen 

申请注册联系人电话:

Applicant telephone:

+86 188 5110 1267

研究负责人电话:

Study leader's
telephone:

+86 138 1369 7258

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

1605573003@qq.com

研究负责人电子邮件:

Study leader's E-mail:

chenbing751@126.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国江苏省南京市鼓楼区丁家桥87号

研究负责人通讯地址:

中国福建省厦门市思明区厦禾路336号

Applicant address:

87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu, China

Study leader's address:

336 Xiahe Road, Siming District, Xiamen, Fujian, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

东南大学

Applicant's institution:

Southeast University

研究负责人所在单位:

厦门大学附属厦门眼科中心

Affiliation of the Leader:

Xiamen Eye Center, Xiamen University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

XMYKZX-KY-2026-009

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

厦门大学附属厦门眼科中心医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Xiamen Eye Center Affiliated to Xiamen University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-03-06 00:00:00

伦理委员会联系人:

黎晓新

Contact Name of the ethic committee:

Xiaoxin Li

伦理委员会联系地址:

中国福建省厦门市思明区厦禾路336号

Contact Address of the ethic committee:

336 Xiahe Road, Siming District, Xiamen, Fujian, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 592 210 9882

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

厦门大学附属厦门眼科中心

Primary sponsor:

Xiamen Eye Center, Xiamen University

研究实施负责(组长)单位地址:

中国福建省厦门市思明区厦禾路336号

Primary sponsor's address:

336 Xiahe Road, Siming District, Xiamen, Fujian, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

福建

市(区县):

Country:

China

Province:

Fujian

City:

单位(医院):

厦门大学附属厦门眼科中心

具体地址:

中国福建省厦门市思明区厦禾路336号

Institution
hospital:

Xiamen Eye Center, Xiamen University

Address:

336 Xiahe Road, Siming District, Xiamen, Fujian, China

经费或物资来源:

自筹

Source(s) of funding:

Self-finance

研究疾病:

屈光不正  

Target disease:

Refractive error

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

飞秒激光小切口角膜基质透镜取出手术(femtosecond laser small incision lenticule extraction,smile)近年来在临床得到广泛推广,软件不断更新技术不断提高,相关认识也在逐步深入,术中的关键之一就是如何从小切口中完整的将角膜基质透镜取出,同时不产生其他并发症,此时医生的操作经验与患者的配合同等重要。与smile术中取透镜的常见并发症有:角膜帽缘撕裂或切口处角膜上皮破损、角膜基质透镜分离困难、角膜基质透镜撕裂或组织残留、寻找角膜基质透镜困难、角膜帽穿孔或划开、非切口处角膜上皮缺损等。Smile是在表面麻醉下激光通过光爆破效应产生微气泡分离角膜基质组织,两次不同深度的基质层激光爆破形成透镜状组织,爆破后分离透镜前角膜层间聚集了密集的气泡,外观极似“过熟期白内障”,此时患者仅存微弱光感视力,患者在医生分离透镜之前几乎处于失明状态难以固视且伴有恐慌心理,医生不得不借助有齿显微镊固定角膜缘组织实施透镜分离,遇到极度紧张或者痛觉敏感的人群导致眼球旋转引起配合度下降,医生又不得不加大显微镊固定的强度又会加剧疼痛和眼球旋转,类似角膜帽缘撕裂或切口处角膜上皮破损、角膜基质边缘透镜撕、角膜帽穿孔或划开、非切口处角膜上皮缺损等相关并发症通常发生于此步骤,解决分离透镜之前瞳孔区角膜层间密集气泡有助于患者固视、减低疼痛提高舒适感、降低相关并发症意义重大。  

Objectives of Study:

Femtosecond laser small incision lenticule extraction (SMILE) has been widely adopted in clinical practice in recent years. As software is continuously updated and technology advances, understanding of the procedure has also deepened. One of the key challenges during surgery is how to extract the corneal lenticule intact through a small incision without causing other complications; in this context, the surgeon’s experience is just as important as the patient’s cooperation. Common complications associated with lenticule extraction during SMILE surgery include: tearing of the corneal flap margin or damage to the corneal epithelium at the incision site; difficulty in separating the corneal stromal lenticule; tearing of the lenticule or residual tissue; difficulty locating the lenticule; perforation or laceration of the corneal flap; and corneal epithelial defects at sites other than the incision. In SMILE, under topical anesthesia, the laser generates microbubbles through the photolysis effect to separate the corneal stroma. Two laser pulses at different depths in the stroma create a lens-shaped structure. After photolysis, dense bubbles accumulate between the corneal layers in front of the lens, giving it an appearance very similar to a "mature cataract." At this stage, the patient retains only faint light perception. Before the surgeon separates the lens, the patient is virtually blind, unable to fixate, and often experiences panic. The surgeon must use toothed microsurgical forceps to stabilize the limbal tissue to perform lens separation. In patients who are extremely anxious or highly sensitive to pain, eye rotation may occur, leading to reduced cooperation. If the surgeon increases the force of the microsurgical forceps to stabilize the tissue, this can exacerbate pain and further induce eye rotation. Complications such as corneal cap margin tears, corneal epithelial damage at the incision site, lens detachment at the corneal stroma margin, corneal cap perforation or laceration, and corneal epithelial defects away from the incision site typically occur during this step. Addressing the dense air bubbles between the corneal layers in the pupillary area prior to lens separation is of significant importance, as it helps patients maintain fixation, reduces pain, enhances comfort, and lowers the risk of related complications.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.患者头位不能处于正常位置 2.重度弱视 3.圆锥角膜或可疑圆锥角膜,其他角膜扩张性疾病及变性 4..角膜过薄,目前可参考但需进一步循证医学支持的标准:预计透镜取出后角膜中央残留基质床厚度<250 μm(一般角膜基质床剩余厚度应至少>250 μm,建议280 μm以上);透镜过薄(<20 μm) 5.. 近期反复发作病毒性角膜炎等角膜疾病、重度干眼、干燥综合征存在活动性眼部病变或感染、严重的眼附属器病变,如眼睑缺损和变形、严重眼睑闭合不全、未控制的青光眼、影响视力的白内障、严重的角膜疾病(如明显的角膜斑翳等角膜混浊、边缘性角膜变性、角膜基质或内皮营养不良以及其他角膜疾病,角膜移植术后、放射状角膜切开术后等角膜手术后,眼外伤)等 6.存在全身结缔组织疾病或自身免疫性疾病,如系统性红斑狼疮、类风湿关节炎,多发性硬化等 7.已知存在焦虑、抑郁等严重心理、精神疾病 8.全身系统性疾病或精神疾病,如癫痫、癔症等致无法配合检查和手术的疾病

Exclusion criteria:

1. The patient’s head cannot be positioned normally 2. Severe amblyopia 3. Keratoconus or suspected keratoconus, other corneal ectatic diseases, and degenerative conditions 4. Corneal thinning. Current criteria for reference, pending further evidence-based medical support: predicted residual central corneal stroma thickness after lens removal <250 μm (generally, residual corneal stroma thickness should be at least >250 μm; 280 μm or greater is recommended); lens thickness <20 μm 5. Recent recurrent episodes of viral keratitis or other corneal diseases, severe dry eye, Sjögren’s syndrome with active ocular lesions or infections, severe adnexal lesions such as eyelid defects and deformities, severe eyelid insufficiency, uncontrolled glaucoma, vision-impairing cataracts, severe corneal diseases (such as corneal opacities including prominent corneal opacities, limbal keratopathy, corneal stromal or endothelial dystrophy, and other corneal diseases; post-corneal surgery, including post-corneal transplant and post-radial keratotomy; ocular trauma) etc. 6. Presence of systemic connective tissue diseases or autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, etc. 7. Known history of severe psychological or psychiatric disorders, such as anxiety or depression 8. Systemic diseases or psychiatric disorders, such as epilepsy or hysteria, that prevent cooperation during examinations and surgery

研究实施时间:

Study execute time:

From 2026-03-20 00:00:00 To 2027-03-20 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-03-20 00:00:00 To 2027-03-19 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

70

Group:

Control group

Sample size:

干预措施:

传统法

干预措施代码:

Intervention:

Traditional Method

Intervention code:

组别:

试验组

样本量:

70

Group:

Experimental Group

Sample size:

干预措施:

新技术

干预措施代码:

Intervention:

Novel technique

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

常州谱瑞眼科医院 

单位级别:

二级 

Institution
hospital:

Changzhou Purui Eye Hospital

Level of the institution:

Secondary

测量指标:

Outcomes:

指标中文名:

视力

指标类型:

主要指标

Outcome:

Vision

Type:

Primary indicator

测量时间点:

术后

测量方法:

Measure time point of outcome:

After surgery

Measure method:

指标中文名:

眼压

指标类型:

主要指标

Outcome:

Intraocular pressure, IOP

Type:

Primary indicator

测量时间点:

术后

测量方法:

Measure time point of outcome:

After surgery

Measure method:

指标中文名:

角膜散光值

指标类型:

主要指标

Outcome:

Corneal astigmatism

Type:

Primary indicator

测量时间点:

术后

测量方法:

Measure time point of outcome:

After surgery

Measure method:

指标中文名:

RMS值

指标类型:

主要指标

Outcome:

RMS value

Type:

Primary indicator

测量时间点:

术后

测量方法:

Measure time point of outcome:

After surgery

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

利用随机化软件生成随机数字表

Randomization Procedure (please state who generates the random number sequence and by what method):

Generation of random number tables using randomization software

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

单盲,即患者不知道自己被分到哪一组

Blinding:

Single-blind, i.e., ,patients do not know which group they are assigned to

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-03-20 09:00:50