Abstract
BackgroundTo measure the decentration following SMILE in eyes with high myopic astigmatism and investigate its impact on visual quality.MethodsThe prospective study was conducted to analyze patients who underwent SMILE for correction of myopia and myopic astigmatism ≥2.5D (high astigmatism group, HA) at the ophthalmology department, Eye and ENT hospital, Shanghai, China.. Patients with myopic astigmatism < 1.5D served as controls (low astigmatism group, LA). Decentration was measured using a Scheimpflug camera with a difference map of the tangential curvature at 12 months postoperatively. Also the associations between decentration from the coaxial sighted corneal light reflex (CSCLR) and the visual outcomes, correction efficacy of astigmatism, wavefront aberrations and objective scatter index (OSI) were analyzed.ResultsNo significant differences were observed in the decentered distance between HA and LA in either eyes (OD: HA: 0.18 ± 0.10 mm, LA: 0.20 ± 0.14 mm, P = 0.659; OS: HA: 0.22 ± 0.11 mm, LA: 0.20 ± 0.11 mm, P = 0.637). The analysis across the three levels of decentration (< 0.1 mm, 0.1–0.2 mm, and > 0.2 mm) showed no significant association between decentration and visual outcomes of predictability, efficiency, safety, MTF cutoff, OSI, SR and OVs in both groups. Also no significant association was observed between decentration and postoperative astigmatism in either group. A significant relationship between the magnitude of decentration and induced coma and spherical aberration was observed in HA.ConclusionsThe amount of decentration between HA and LA groups showed no differences. Decentration > 0.20 mm from CSCLR resulted in greater induction of coma and SA after SMILE in eyes with HA.
Highlights
To measure the decentration following Small-incision lenticule extraction (SMILE) in eyes with high myopic astigmatism and investigate its impact on visual quality
No significant difference was found in the distribution of pupil centers with respect to coaxial sighted corneal light reflex (CSCLR) between high astigmatism (HA) and Low astigmatism group (LA) groups in either of the eyes (OD: Mann-Whitney U, P = 0.689; OS: Mann-Whitney U, P = 0.758, Fig. 1)
No significant correlation was found between the magnitude of Chord mu and the wavefront aberration, modulation transfer function (MTF) cutoff and objective scatter index (OSI) in both the groups
Summary
To measure the decentration following SMILE in eyes with high myopic astigmatism and investigate its impact on visual quality. Small-incision lenticule extraction (SMILE) is an all-inone procedure, in which a femtosecond lasers were used to perform intrastromal lenticule creation that is manually extracted through a small side incision. SMILE technology exhibited excellent efficacy, safety, stability and predictability in the correction of both myopia as well as. Huang et al BMC Ophthalmology (2019) 19:151 between anterior keratometric astigmatism and decentration distance in eyes following SMILE surgery, and the preoperative cylindrical error was 1.0 diopters [9]. There are few studies that investigated the effects of high astigmatism (HA) on decentration during SMILE surgery. We conducted a prospective study to determine the characteristics of lenticular decentration following SMILE in eyes with high astigmatism (HA) and to investigate the relationship between decentration and visual outcomes
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