University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany.
SMILE Eyes Clinic, Linz, Austria.
Acta Ophthalmol. 2020 Nov;98(7):e907-e913. doi: 10.1111/aos.14420. Epub 2020 Mar 25.
To analyse in depth the associations between objectively measured corneal higher-order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire.
This cross-sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients' subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances.
A total of 394 eyes of 197 patients with a mean age of 32.4 ± 7.7 years and a mean postoperative follow-up of 24.3 ± 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 ± 0.131 µm), coma (0.142 ± 0.179 µm), trefoil (0.018 ± 0.067 µm) as well as in total HOAs (0.191 ± 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164).
Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient-reported QOV or specific long-term visual symptoms.
深入分析小切口微透镜提取术（SMILE）后，通过标准化和临床验证的视觉质量（QOV）问卷定量评估的角膜高阶像差（HOA）与主观视觉质量感知之间的相关性。
这项横断面研究纳入了双侧同时接受 SMILE 治疗近视和/或近视散光且目标屈光度为平光的患者。采用 Scheimpflug 成像（Pentacam HR；Oculus Optikgeräte GmbH，德国威茨拉尔）客观量化角膜 HOA。采用标准化和验证的 QOV 问卷评估患者对视觉干扰的频率、严重程度和困扰程度的主观感知视觉质量。
共纳入 197 例患者的 394 只眼，平均年龄为 32.4±7.7 岁，平均术后随访时间为 24.3±14.1 个月。SMILE 术引起球差（0.074±0.131µm）、彗差（0.142±0.179µm）、三叶草差（0.018±0.067µm）和总 HOA（0.191±0.176µm）显著增加，差异有统计学意义（p<0.001）。手术诱导和术后 HOA 水平与代表整体视觉症状频率、严重程度和困扰效应的三个 QOV 评分均无相关性（所有 R 值均≤0.016）。此外，特定视觉症状（如星爆）与单一 HOA 项（如光环）之间的相关性非常弱（所有 Rho 值均≤0.164）。
小切口微透镜提取术引起了大量的角膜 HOA，但与患者报告的 QOV 或特定的长期视觉症状之间没有明确的关系。
