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Clinical Outcomes of Small Incision Lenticule Extraction in Myopia: Study of Vector Parameters and Corneal Aberrations

Korean Journal of Ophthalmology 2020년 34권 1호 p.76 ~ 84
 ( Kwak Jay Ji-Yong ) - Yonsei University College of Medicine Department of Ophthalmology

전익현 ( Jun Ik-Hyun ) - Yonsei University College of Medicine Department of Ophthalmology
김응권 ( Kim Eung-Kweon ) - Yonsei University College of Medicine Department of Ophthalmology
서경률 ( Seo Kyoung-Yul ) - Yonsei University College of Medicine Department of Ophthalmology
김태임 ( Kim Tae-Im ) - Yonsei University College of Medicine Department of Ophthalmology

Abstract


Purpose: To investigate clinical outcomes of small incision lenticule extraction (SMILE) including vector parameters and corneal aberrations in myopic patients.

Methods: This retrospective, observational case series included 57 eyes (29 patients) that received treatment for myopia using SMILE. Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry, corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at 1 and 3 months after surgery. We analyzed the safety, efficacy, vector parameters, and corneal aberrations at 3 months after surgery.

Results: Preoperatively, mean manifest refraction spherical equivalent refraction was ?4.94 ± 1.94 D (range, ?8.25 to 0 diopters [D]), and the cylinder was ?1.14 ± 0.82 D (range, ?3 to 0 D). Mean manifest refraction spherical equivalent improved to ?0.10 ± 0.23 D at 3 months postoperatively, when uncorrected distance visual acuity was 20 / 20 or better in 55 (96%) eyes. The linear regression model of target induced astigmatism vector versus surgically induced astigmatism vector exhibited slopes and coefficients (R2) of 0.9618 and 0.9748, respectively (y = 0.9618x + 0.0006, R2 = 0.9748). While total corneal root mean square higher order aberrations, coma and trefoil showed statistically significant increase, spherical aberration did not show statistically significant change after SMILE.

Conclusions: SMILE has proven to be effective and safe for correcting myopia and astigmatism. We showed that SMILE did not induce spherical aberrations. A small increase in postoperative corneal higher order aberration may be associated with increase in coma and trefoil.

키워드

Astigmatism; Corneal wavefront aberration; Refractive surgical procedures; Small incision lenticule extraction; Vector analysis
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