Impact of Treatment Decentration on Higher-Order Aberrations after SMILE

Yu, Ying; Zhang, Wenwen; Cheng, Xinliang; Cai, Jianru; Chen, Hui

doi:10.1155/2017/9575723

Cited by 15 publications

(12 citation statements)

References 23 publications

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“…Previous studies indicated that centeration and wound healing might influence the induction of coma aberrations [ 18 , 19 ]. Li et al demonstrated that horizontal decentration induced horizontal coma aberrations but that there appeared to be no association between the magnitude of vertical decentration and induction of vertical coma aberrations [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia

Jin

Wan

et al. 2018

BMC Ophthalmol

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BackgroundTo investigate corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE) in high myopic and mild to moderate myopic patients.MethodsThis retrospective study included 197 eyes (101 patients) undergoing SMILE surgery. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: a high myopic group (more than − 6.0 D, Group H) and a mild to moderate myopic group (less than − 6.0 D, Group M). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured using a Scheimpflug camera preoperatively and 3 months postoperatively. Pearson’s correlation analysis was conducted to determine relationships between corneal aberrations and the SE.ResultsThere were no significant differences in third-order to eight-order aberrations (RMS HOAs) of the anterior surface, posterior surface, and total corneal between the two groups before SMILE surgery. However, after SMILE, anterior and total corneal HOAs, especially vertical coma and spherical aberrations, significantly increased in both groups (p < 0.0167), whereas posterior corneal HOAs remained relatively stable (p > 0.0167). The induction of HOAs was significantly greater in Group H than Group M postoperatively (p < 0.0167). Changes in anterior surface and total corneal HOAs, especially vertical coma and spherical aberrations, were related to the SE (p < 0.05).ConclusionsAnterior and total corneal HOAs, particularly vertical coma and spherical aberrations, significantly increased after SMILE in both groups, whereas posterior corneal HOAs remained stable. Aberration changes were related to SE.Trial registrationRetrospectively registered. ChiCTR-ORC-17011040. Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 15 December 2016.

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Section: Discussionmentioning

confidence: 99%

Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia

Jin

Wan

et al. 2018

BMC Ophthalmol

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“…However, values of R 2 revealed in regression models were not high enough to completely predict the changes, suggesting that there were other possible factors affecting the corneal spherical aberration. For example, corneal biomechanical properties [ 5 ] and treatment decentration [ 22 ] had been reported to be associated with the induced spherical aberration.…”

Section: Discussionmentioning

confidence: 99%

Corneal Spherical Aberration and Corneal Asphericity after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK

Zhang

Wang

2017

Journal of Ophthalmology

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Purpose To investigate corneal spherical aberration and corneal asphericity after small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods This study enrolled 70 patients having SMILE and 64 subjects receiving FS-LASIK. The preoperative spherical equivalent (SE) was −5.83 ± 1.23 diopters (D) and −6.20 ± 1.52 D, respectively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, corneal spherical aberration, and asphericity over the 6.0 mm cornea were evaluated preoperatively and postoperatively. Results At 6 months, the UDVA, CDVA, and SE were −0.12 ± 0.11, −0.05 ± 0.05, and −0.16 ± 0.19 D in SMILE and −0.10 ± 0.06, −0.03 ± 0.06, and −0.08 ± 0.25 D in FS-LASIK. There was no difference between groups in the postoperative UDVA, CDVA, or SE (P > 0.05). SMILE showed lower inductions of spherical aberration along the anterior surface and the total cornea and less increases in corneal asphericity of the anterior surface postoperatively than FS-LASIK (P < 0.01). There were significant correlations between the changes in spherical aberration and corneal asphericity (P < 0.001). Conclusions SMILE and FS-LASIK exhibited excellent visual results and refractive outcomes. SMILE induced less increase in corneal spherical aberration and better preserved the corneal asphericity of the anterior corneal surface than FS-LASIK. Corneal asphericity changes contributed to the corneal spherical aberration changes following SMILE and FS-LASIK.

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“…12 It is noteworthy that vertical decentration was observed more common among the lenticule decentrations, and postoperative induced HOAs, including vertical coma and spherical aberration occurred more frequently among the surgeons at their early learning stage. 10,11,17,18…”

Section: Main Centration Axes In Corneal Refractive Surgerymentioning

confidence: 99%

Review on Centration, Astigmatic Axis Alignment, Pupil Size and Optical Zone in SMILE

Liu

Yang

Lin

et al. 2019

Asia-Pacific Journal of Ophthalmology

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The advent of “flapless” small-incision lenticule extraction (SMILE), employing all-in-one technology, has resulted in a revolutionary breakthrough in refractive surgeries. SMILE has been gaining popularity due to fewer potential complications, such as postoperative dry eyes and greater biomechanical stability, etc. However, attention must be given to 1) the centration on the corneal vertex, 2) the proper alignment of the astigmatic axis, and 3) the relationship between pupil size and treatment diameter, to achieve good SMILE results. There is no pupil-tracking system to ascertain the accuracy of centration during the SMILE surgery. To improve the centration accuracy, our center uses two corneal topographers (Pentacam and Sirius) to measure and determine corneal vertex. Proper predicted optical zone diameter is not clearly defined yet in SMILE. Some scholars insist that mesopic pupil size should be taken into consideration when setting the predicted optical zone. Meanwhile, the issue of “functional optical zone” still has many unresolved issues and warrants further studies.

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Impact of Treatment Decentration on Higher-Order Aberrations after SMILE

Cited by 15 publications

References 23 publications

Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia

Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia

Corneal Spherical Aberration and Corneal Asphericity after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK

Review on Centration, Astigmatic Axis Alignment, Pupil Size and Optical Zone in SMILE

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