Clinical Outcomes of Small Incision Lenticule Extraction in Myopia: Study of Vector Parameters and Corneal Aberrations
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Purpose: To investigate clinical outcomes of small incision lenticule extraction (SMILE) including vector parametersand corneal aberrations in myopic patients. Methods: This retrospective, observational case series included 57 eyes (29 patients) that received treatmentfor myopia using SMILE. Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry,corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at1 and 3 months after surgery. We analyzed the safety, efficacy, vector parameters, and corneal aberrations at3 months after surgery. Results: Preoperatively, mean manifest refraction spherical equivalent refraction was -4.94 ± 1.94 D (range,-8.25 to 0 diopters [D]), and the cylinder was -1.14 ± 0.82 D (range, -3 to 0 D). Mean manifest refraction sphericalequivalent improved to -0.10 ± 0.23 D at 3 months postoperatively, when uncorrected distance visual acuitywas 20 / 20 or better in 55 (96%) eyes. The linear regression model of target induced astigmatism vectorversus surgically induced astigmatism vector exhibited slopes and coefficients (R2) of 0.9618 and 0.9748, respectively(y = 0.9618x + 0.0006, R2 = 0.9748). While total corneal root mean square higher order aberrations,coma and trefoil showed statistically significant increase, spherical aberration did not show statistically significantchange after SMILE. Conclusions: SMILE has proven to be effective and safe for correcting myopia and astigmatism. We showedthat SMILE did not induce spherical aberrations. A small increase in postoperative corneal higher order aberrationmay be associated with increase in coma and trefoil.
Abstract
Purpose: To investigate clinical outcomes of small incision lenticule extraction (SMILE) including vector parametersand corneal aberrations in myopic patients. Methods: This retrospective, observational case series included 57 eyes (29 patients) that received treatmentfor myopia using SMILE. Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry,corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at1 and 3 months after surgery. We analyzed the safety, efficacy, vector parameters, and corneal aberrations at3 months after surgery. Results: Preoperatively, mean manifest refraction spherical equivalent refraction was -4.94 ± 1.94 D (range,-8.25 to 0 diopters [D]), and the cylinder was -1.14 ± 0.82 D (range, -3 to 0 D). Mean manifest refraction sphericalequivalent improved to -0.10 ± 0.23 D at 3 months postoperatively, when uncorrected distance visual acuitywas 20 / 20 or better in 55 (96%) eyes. The linear regression model of target induced astigmatism vectorversus surgically induced astigmatism vector exhibited slopes and coefficients (R2) of 0.9618 and 0.9748, respectively(y = 0.9618x + 0.0006, R2 = 0.9748). While total corneal root mean square higher order aberrations,coma and trefoil showed statistically significant increase, spherical aberration did not show statistically significantchange after SMILE. Conclusions: SMILE has proven to be effective and safe for correcting myopia and astigmatism. We showedthat SMILE did not induce spherical aberrations. A small increase in postoperative corneal higher order aberrationmay be associated with increase in coma and trefoil.
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