Abstract
BackgroundTo evaluate clinical outcomes after full-thickness astigmatic keratotomy (FTAK) combined with small-incision lenticule extraction (SMILE) in eyes with high astigmatism.MethodsThis study comprised 75 eyes of 43 patients with over 4.0 diopters (D) of astigmatism who were treated with SMILE after FTAK. Visual acuities and refractive measurements were evaluated at 1 month after FTAK, and 1, 6, 12, and 24 months after SMILE. Vector analysis of the astigmatic changes was performed using the Alpins method.ResultsTwenty-four months after the combined procedure, the average spherical equivalent was reduced from − 6.56 ± 2.38 D to − 0.36 ± 0.42 D (p < 0.001). The uncorrected and corrected distance visual acuities improved from 1.54 ± 5.53 to − 0.02 ± 0.09 and from − 0.03 ± 0.07 D to − 0.07 ± 0.08 D (both p < 0.001), respectively. The preoperative mean astigmatism was − 5.48 ± 1.17 D, which was reduced to − 2.27 ± 0.97 D and − 0.34 ± 0.26 D at 1 month after FTAK and 24 months after SMILE, respectively (p < 0.001). The surgically-induced astigmatism after FTAK, SMILE, and FTAK and SMILE combined was 3.38 ± 1.18 D, 2.22 ± 0.84 D, and 5.39 ± 1.20 D, respectively. Furthermore, the correction index of FTAK, SMILE, and FTAK and SMILE combined was 0.63 ± 0.17, 0.90 ± 0.40, and 0.98 ± 0.06, respectively. There were no intraoperative or postoperative complications.ConclusionOur surgical procedure combining FTAK and SMILE showed good and stable clinical outcomes during two-year follow-up for the treatment of high astigmatism.
Highlights
To evaluate clinical outcomes after full-thickness astigmatic keratotomy (FTAK) combined with smallincision lenticule extraction (SMILE) in eyes with high astigmatism
While no significant change in spherical equivalent (SE) was observable 1 month after FTAK (p = 0.357), the astigmatism reduced from − 5.48 ± 1.17 D to − 2.31 ± 0.86 D, 1 month after FTAK (p < 0.001)
Some authors reported no significant difference in decentration between laser in situ keratomileusis (LASIK) and SMILE [11, 12], and Chan et al [12] found no significant association between decentration and astigmatic correction after LASIK and SMILE
Summary
To evaluate clinical outcomes after full-thickness astigmatic keratotomy (FTAK) combined with smallincision lenticule extraction (SMILE) in eyes with high astigmatism. Small-incision lenticule extraction (SMILE) is a flapless, all-femtosecond laser-based technique for correcting myopia and myopic astigmatism, which has gained widespread acceptance due to its good predictability, safety, and efficacy [1–3]. We reported good short-term clinical outcomes after using a surgical procedure combining cc and SMILE for patients who were inoperable using SMILE alone due to high astigmatism [7]. We only analyzed the magnitude of astigmatic correction by FTAK and SMILE did not perform vector analysis. We retrospectively analyzed the clinical outcomes after SMILE preceded by FTAK for eyes with over 4.0 D astigmatism. Astigmatic changes were analyzed after each procedure individually and after the two of them using vector analysis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
