PURPOSE To describe the therapeutic use of CIRCLE software (Carl Zeiss Meditec, Jena, Germany) for the management of retained lenticule tissue after complicated small incision lenticule extraction (SMILE). METHODS Two patients were referred for consultation and treatment due to intraoperative complications during SMILE. In case 1, a black patch during laser delivery caused the lenticule to be torn irregularly from the undersurface during extraction and a sliver of it was retained in the pocket. Case 2 presented with false plane dissection and a completely retained lenticule on anterior segment optical coherence tomography. Both cases were managed using the CIRCLE software by converting the cap into a flap, thus making access to the interface possible. RESULTS In case 1, after lifting the flap a small sliver of tissue was found in the interface, which was dissected, following which a 20-µm phototherapeutic keratectomy was done to smooth the interface. In case 2, after lifting the flap the edge of the retained lenticule was identified by using an endoilluminator and the lenticule was separated and subsequently removed. Both cases showed significant improvement in uncorrected distance visual acuity, corrected distance visual acuity, and Objective Scatter Index score on day 1 after repair surgery. CONCLUSIONS CIRCLE software may be successfully used for managing retained lenticule tissue apart from performing enhancement after SMILE. [J Refract Surg. 2019;35(1):60-65.].

中文翻译：

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用于复杂SMILE手术后保留小孔组织管理的CIRCLE软件。

目的描述CIRCLE软件（Carl Zeiss Meditec，耶拿，德国）在复杂小切口小孔镜摘除术（SMILE）处理后保留的小镜膜组织的治疗用途。方法2例因SMILE术中并发症而被转诊并接受治疗的患者。在情况1中，在激光传输过程中出现黑色斑点，导致在提取过程中小透镜从下表面不规则地撕裂，并且其中一小部分保留在袋中。病例2在前段光学相干断层扫描中表现为假平面解剖，并完全保留了小透镜。两种情况均使用CIRCLE软件进行管理，方法是将瓶盖转换为翻盖，从而可以访问界面。结果在案例1中，提起皮瓣后，在接口处发现了小块组织，进行解剖，然后进行20 µm的光治疗性角膜切除术以使界面光滑。在情况2中，提起襟翼后，使用内照明器识别保留的小透镜的边缘，然后分离小透镜并随后将其取出。两种情况均显示修复手术后第1天的未矫正远距离视敏度，矫正远距离视敏度和客观散布指数评分显着改善。结论除了在SMILE后进行增强外，CIRCLE软件可以成功地用于管理保留的小囊组织。[J Refract Surg。2019; 35（1）：60-65。]。提起皮瓣后，使用内照明器识别保留的小孔边缘，然后分离小孔然后取出。两种情况均显示修复手术后第1天的未矫正远视力，矫正远视力和客观散布指数评分显着改善。结论除了在SMILE后进行增强外，CIRCLE软件可以成功地用于管理保留的小囊组织。[J Refract Surg。2019; 35（1）：60-65。]。提起皮瓣后，使用内照明器识别保留的小孔边缘，然后分离小孔然后取出。两种情况均显示修复手术后第1天的未矫正远距离视敏度，矫正远距离视敏度和客观散布指数评分显着改善。结论除了在SMILE后进行增强外，CIRCLE软件可以成功地用于管理保留的小囊组织。[J Refract Surg。2019; 35（1）：60-65。]。结论除了在SMILE后进行增强外，CIRCLE软件可以成功地用于管理保留的小囊组织。[J Refract Surg。2019; 35（1）：60-65。]。结论除了在SMILE后进行增强外，CIRCLE软件可以成功地用于管理保留的小囊组织。[J Refract Surg。2019; 35（1）：60-65。]。