Department of Ophthalmology, Peking University Third Hospital, No 49 Huayuan North Road, Haidian District, Beijing, 100191, China.
Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Institute of Laser Medicine, Beijing, China.
Int Ophthalmol. 2023 Nov;43(11):3935-3942. doi: 10.1007/s10792-023-02794-z. Epub 2023 Jul 6.
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.
Peking University Third Hospital, Beijing, China.
This was a retrospective observational study.
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.
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).
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.
本研究旨在描述小切口角膜基质透镜取出术（SMILE）后的主观视觉质量和满意度，并确定其影响因素。
中国北京，北京大学第三医院。
这是一项回顾性观察研究。
纳入双眼行 SMILE 治疗近视和近视散光的患者，术后 6 个月采用患者报告的结果问卷评估真实生活环境下的视觉质量。应用 Sirius 角膜地形图仪和角膜共焦显微镜进行检查，包括斯特列尔比（SR）、6mm 范围内角膜高阶像差（HOAs）、kappa 角和最薄角膜厚度等参数。基于术前后切向差异图测量偏心度和有效光区（EOZ）。采用二元逻辑回归分析预测患者报告的视觉质量。
回顾性分析 97 例临床资料。总体满意度为 96.91%（94/97）。视力波动和眩光最常见且占主导地位。SR 值与术前相比无显著增加（P>0.05）。总 HOAs、球差和彗差显著增加（P<0.05）。SR 和 HOAs 与视觉症状的严重程度无相关性（P>0.05）。SMILE 术后未发现任何客观参数与患者报告的视觉质量相关（P>0.05）。
SMILE 术后患者报告的高满意度证实了其在真实生活环境下对视觉质量的理想效果，尽管一些客观光学性能并不理想。SMILE 对患者条件和轻微偏差具有很强的容忍性，本研究未发现影响视觉性能的因素。
