The effects of programmed optical zones on achieved corneal refractive power with myopic astigmatism after small incision lenticule extraction (SMILE): a vector analysis

Int Ophthalmol. 2023 Jul;43(7):2493-2501. doi: 10.1007/s10792-023-02649-7. Epub 2023 Mar 11.

Abstract

Purpose: To evaluate the effects of different programmed optical zones (POZs) on achieved corneal refractive power (CRP) with myopic astigmatism after small incision lenticule extraction (SMILE).

Methods: In total, 113 patients (113 eyes) were included in this retrospective study. The eyes were divided into two groups according to POZ: group A (6.5, 6.6, and 6.7 mm, n = 59) and group B (6.8, 6.9, and 7.0 mm, n = 54). Fourier vector analysis was applied to evaluate the error values between the attempted and achieved corneal refractive power (CRP). Alpins vector analysis was used to calculate surgically induced astigmatism (SIA), difference vector (DV), magnitude of error (ME), and astigmatism correction index (ACI). Multivariate regression analysis was performed to assess potential factors associated with the error values.

Results: The error values in the group with large POZ were closer to zero, and significantly associated with the POZ at 2 and 4 mm of the cornea (β = - 0.50, 95% confidence interval [CI] [- 0.80, - 0.20]; β = - 0.37, 95% CI [- 0.63, - 0.10], P < 0.05, respectively). For the correction of astigmatism, the values of SIA, ME, and ACI were lower in group B than in group A (P < 0.05). The fitting curves between TIA and SIA were y = 0.83x + 0.19 (R2 = 0.84) and y = 1.05x + 0.04 (R2 = 0.90), respectively.

Conclusions: Smaller POZs resulted in higher error values between the achieved- and attempted-CRP in the SMILE procedure, which should be considered when performing surgery.

Keywords: Corneal refractive power; Myopic astigmatism; Programmed optical zone; Vector analysis.

MeSH terms

  • Astigmatism* / diagnosis
  • Astigmatism* / etiology
  • Astigmatism* / surgery
  • Cornea / surgery
  • Corneal Stroma / surgery
  • Corneal Surgery, Laser* / adverse effects
  • Corneal Surgery, Laser* / methods
  • Humans
  • Lasers, Excimer / therapeutic use
  • Myopia* / surgery
  • Refraction, Ocular
  • Retrospective Studies
  • Visual Acuity