Abstract
BackgroundTo compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality.MethodsSixty-five myopic eyes from 38 patients were enrolled in the study retrospectively, either having undergone SMILE or WFG FS-LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, and individual Zernike coefficients of 3rd- to 6th-order HOAs were measured before and 3 months after the surgeries and were compared using the Mann-Whitney test or Student’s t-test. Additional generalized estimating equation analyses (GEE) were used to control for within-subject biases in individual Zernike coefficients between the right and left eyes of the same patients.ResultsThere was no significant difference in UDVA or CDVA after WFG FS-LASIK (Mean ± SD: −0.02 ± 0.07 and −0.04 ± 0.22 respectively, in logMAR) and after SMILE (−0.01 ± 0.06 and −0.04 ± 0.04 respectively). However, greater vertical coma aberration was found after SMILE (p = 0.036). Preoperative SE was correlated to induced horizontal coma (r = −0.608, p = 0.001) in WFG FS-LASIK, and correlated to induced vertical coma (r = −0.459, p = 0.003) in SMILE.ConclusionsBoth SMILE and WFG FS-LASIK can achieve planned visual outcomes in correcting myopia and myopic astigmatism. However, higher vertical coma was shown in SMILE than WFG FS-LASIK which might be a potentially impact factor for patients’ vision under certain lighting conditions and needs further investigation.
Highlights
To compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-laser in-situ keratomileusis (LASIK)), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality
There was no significant difference in any of the variables between the SMILE and WFG FSLASIK groups
The present study showed that 97% of eyes after SMILE and 100% of eyes after WFG FS-LASIK met this criterion, this is comparable to earlier studies [17,18,19,20, 22,23,24]
Summary
To compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality. Femtosecond laser (FL) utilizes ultrafast pulses to create precise ocular tissue ablation [1], and is commonly used in corneal refractive surgeries to create corneal flaps in femtosecond laser-assisted in situ keratomileusis. FL has increasingly been used to create a transparent refractive lenticule in femtosecond lenticule extraction (FLEx) with a lifted corneal flap, and in SMILE has been considered as an alternative procedure to conventional laser in-situ keratomileusis (LASIK) because of its potential advantages of reduced denervation, faster resolution of post-operative dry eye, improved biomechanics, and no flap-related risks [3,4,5,6].
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