Comparison of efficacy and visual quality after CWFG-FS-LASIK, AF-FS-LASIK and SMILE for correcting myopia with asymmetry mid-to-high astigmatism

Abstract

Background The individualized ablation is not only able to correct corneal low-order aberrations but also improve the corneal high-order aberrations in corneal asymmetry patients. In this study, we compared the effect of patients with mid-to-high astigmatism asymmetric corneas (1-4D) after three different surgical methods: Selective coma guidance femtosecond Laser in-situ keratomileusis (CWFG-FS-LASIK),Aberration-Free femtosecond Laser in-situ keratomileusis (AF-FS-LASIK) and Small incision lenticule (SMILE).Methods One hundred and fourteen eyes from 58 patients were enrolled in the retrospective study. We measured and compared the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), residual astigmatism, total coma, vertical coma (Z3-1), horizontal coma (Z31), Modulation Transfer Function (MTF) and Point Spread Function (PSF) at preoperation and postoperation after three months.Results Visual acuity of patients in three groups was increased after surgeries, but the improvements of visual acuity and residual astigmatism among them were no significant differences. However, the improvements of 4mm and 6mm total coma, Z3-1 and Z31 in CWFG-FS-LASIK were superior than in AF-FS-LASIK and SMILE. Consistent with this, the improvements of MTF and PSF (3mm and 5mm) in CWFG-FS-LASIK were better than in AF-FS-LASIK and SMILE.Conclusions In surgeries for treating patients with mid-to-high astigmatism in asymmetric corneas, the selective coma-guided mode was able to decrease the coma of original cornea, improve visual acuity and optimize the visual quality of patients.