Huang Jia, Zhou Xingtao, Qian Yishan
Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, People's Republic of China.
NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China.
BMC Ophthalmol. 2019 Jul 17;19(1):151. doi: 10.1186/s12886-019-1153-7.
To measure the decentration following SMILE in eyes with high myopic astigmatism and investigate its impact on visual quality.
The prospective study was conducted to analyze patients who underwent SMILE for correction of myopia and myopic astigmatism ≥2.5D (high astigmatism group, HA) at the ophthalmology department, Eye and ENT hospital, Shanghai, China.. Patients with myopic astigmatism < 1.5D served as controls (low astigmatism group, LA). Decentration was measured using a Scheimpflug camera with a difference map of the tangential curvature at 12 months postoperatively. Also the associations between decentration from the coaxial sighted corneal light reflex (CSCLR) and the visual outcomes, correction efficacy of astigmatism, wavefront aberrations and objective scatter index (OSI) were analyzed.
No significant differences were observed in the decentered distance between HA and LA in either eyes (OD: HA: 0.18 ± 0.10 mm, LA: 0.20 ± 0.14 mm, P = 0.659; OS: HA: 0.22 ± 0.11 mm, LA: 0.20 ± 0.11 mm, P = 0.637). The analysis across the three levels of decentration (< 0.1 mm, 0.1-0.2 mm, and > 0.2 mm) showed no significant association between decentration and visual outcomes of predictability, efficiency, safety, MTF cutoff, OSI, SR and OVs in both groups. Also no significant association was observed between decentration and postoperative astigmatism in either group. A significant relationship between the magnitude of decentration and induced coma and spherical aberration was observed in HA.
The amount of decentration between HA and LA groups showed no differences. Decentration > 0.20 mm from CSCLR resulted in greater induction of coma and SA after SMILE in eyes with HA.
测量高度近视散光眼行全飞秒激光微小切口基质透镜切除术（SMILE）后的偏心情况，并研究其对视觉质量的影响。
本前瞻性研究对在中国上海眼耳鼻喉科医院眼科接受SMILE矫正近视及近视散光≥2.5D（高度散光组，HA）的患者进行分析。近视散光<1.5D的患者作为对照组（低度散光组，LA）。术后12个月使用眼前节分析系统通过切线曲率差异图测量偏心情况。同时分析与同轴视轴角膜反光点（CSCLR）的偏心与视觉结果、散光矫正效果、波前像差和客观散射指数（OSI）之间的相关性。
HA组和LA组两眼的偏心距离均无显著差异（右眼：HA组：0.18±0.10mm，LA组：0.20±0.14mm，P = 0.659；左眼：HA组：0.22±0.11mm，LA组：0.20±0.11mm，P = 0.637）。对三个偏心水平（<0.1mm、0.1 - 0.2mm和>0.2mm）进行分析，结果显示两组中偏心与可预测性、有效性、安全性、调制传递函数截止频率、OSI、斯特列尔比（SR）和视觉质量（OVs）的视觉结果之间均无显著相关性。两组中偏心与术后散光之间也未观察到显著相关性。在HA组中观察到偏心程度与诱导性彗差和球差之间存在显著关系。
HA组和LA组之间的偏心量无差异。对于HA眼，SMILE术后CSCLR偏心>0.20mm会导致更大程度的彗差和球差诱导。
