Subjective patient-reported visual quality after small-incision lenticule extraction and its correlation to the objective one.

PURPOSE

The purpose of the study was to characterize the subjective visual quality and satisfaction following small-incision lenticule extraction (SMILE) and to identify its influential factors.

SETTING

Peking University Third Hospital, Beijing, China.

DESIGN

This was a retrospective observational study.

METHODS

Patients who had simultaneous binocular SMILE for myopia and myopic astigmatism were included 6 months postoperatively, and the patient-reported outcome questionnaire was employed for the assessment of visual quality in real-life situations. Examinations with SIRIUS combined corneal topography and tomography were performed including the parameters of Strehl ratio (SR), corneal higher-order aberrations (HOAs) within 6.0-mm area, kappa angel, and thinnest corneal thickness. Decentration and effective optical zone (EOZ) were measured based on a tangential pre-post-operation difference map. Binary logistic regression analysis was performed for predictors of patient-reported visual quality.

RESULTS

Clinical data from 97 cases were analyzed retrospectively. Overall satisfaction was 96.91% (94/97). Fluctuation in vision and glare is the most frequent and dominant visual symptoms. SR value increased non-significantly compared with preoperative (P> 0.05). A statistically significant (P < 0.05) increase in total HOAs, spherical aberration, and coma was noted. SR and HOAs were not correlated with the degree of visual symptoms (P > 0.05). No objective parameter was found to be associated with patient-reported visual quality after SMILE (P> 0.05).

CONCLUSION

The high patient-reported satisfaction confirmed the ideal effect on visual quality following SMILE in real-life situations, though some objective optical performances were not satisfying. It is very tolerant toward patients' conditions and mild deviations, and this study did not find factors affecting visual performances.