Abstract
BackgroundTo investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction.MethodsA total of 32 eyes of 32 patients with no strabismus who underwent SMILE were enrolled in this prospective clinical study. The accommodative response was obtained viewing monocularly with spherical equivalent refractive error corrected, using an open-field autorefractor at different stimulus levels (2.00D, 2.50D, 3.00D, 4.00D and 5.00D) for the right eye before a standard SMILE surgery and at 1-month follow-up after surgery.ResultsThe mean age of the patients were 23.34 ± 2.90 years and the mean preoperative manifest refraction spherical equivalent was −5.74 ± 1.98 diopters. Significant differences were detected in both preoperative and postoperative accommodative responses to different stimulus levels (P < 0.001). Multiple linear regression model analysis revealed preoperative manifest refractive spherical equivalent (P = 0.006) and preoperative accommodative lag (P = 0.04) showed a significant impact on postoperative accommodative lag.ConclusionsThis is the first report of accommodative changes after SMILE. Our preliminary results showed that a decrease in postoperative accommodative lag that might be related to the relief of the visual discomfort symptom.
Highlights
To investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction
We studied the accommodative response and accommodative lag changes after SMILE for moderate to high myopia correction
It is believed that some discrepancy between accommodative demand and accommodative response is normal though no criteria has been made yet
Summary
To investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction. Femtosecond laser small incision lenticule extraction (SMILE) was first introduced by Shah and Sekundo in 2011 and improved with continuous curvilinear lenticulerrhexis (CCL) technique by Zhou in 2015 [1,2,3]. SMILE is an effective and safe refractive surgery with a small incision and flapless feature [4]. Accommodation is an old theme in visual refraction. Accommodation is the ability to adjust the refractive power of the eye to bring the conjugate focus of the retina identical to an object. The accommodative lag has been investigated to have a positive correlation with the symptoms of near-related visual discomfort [5,6,7].
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