Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
BMC Ophthalmol. 2024 May 13;24(1):211. doi: 10.1186/s12886-024-03475-w.
To investigate the correlation between higher-order aberrations (HOA) after small incision lenticule extraction (SMILE) and the severity of myopia and astigmatism, along with the relevant factors. These findings will provide valuable insights for decreasing the occurrence of HOA after SMILE and enhancing visual quality.
A total of 75 patients (150 eyes) with myopia and astigmatism who underwent SMILE were categorized into four groups based on the severity of myopia and astigmatism: Myopia Group 1 (Group M1, spherical diopter ranged from -1.00 D to -4.00 D), Myopia Group 2 (Group M2, spherical diopter ranged from -4.10 D to -10.00 D), Astigmatism Group 1 (Group A1, cylindrical diopter ranged from 0 D to -1.00 D), and Astigmatism Group 2 (Group A2, cylindrical diopter ranged from -1.10 D to -3.00 D). A comprehensive assessment was performed to examine the association between HOA and various relevant factors, including a detailed analysis of the subgroups.
Group M1 had significantly lower levels of total eye coma aberration (CA), corneal total HOA (tHOA), internal tHOA, and vertical CA ( ) after SMILE than Group M2 (P < 0.05). Similarly, Group A1 had significantly lower levels of total eye tHOA, CA, trefoil aberration (TA), corneal tHOA, TA, and vertical TA ( ) after SMILE than Group A2 (P < 0.05). Pearson correlation analysis indicated a statistically significant positive relationship between the severity of myopia/astigmatism and most HOA (P < 0.05). Subgroup evaluations demonstrated a notable increase in postoperative HOA associated with myopia and astigmatism in Groups M2 and A2 compared with the control group. Lenticule thickness, postoperative central corneal thickness (CCT), postoperative uncorrected distance visual acuity (UDVA), and postoperative corneal Km and Cyl were strongly correlated with most HOA. Age, eyes, and postoperative intraocular pressure (IOP) were only associated with specific HOA.
HOA positively correlated with the severity of myopia and astigmatism after SMILE. However, this relationship was not linear. HOA after SMILE was influenced by various factors, and additional specialized investigations are required to establish its clinical importance.
探讨小切口透镜切除术（SMILE）后高阶像差（HOA）与近视和散光严重程度的相关性，以及相关因素。这些发现将为降低 SMILE 术后 HOA 的发生并提高视觉质量提供有价值的参考。
将 75 例（150 只眼）近视散光患者按近视散光严重程度分为 4 组：近视 1 组（M1 组，球镜屈光度-1.00 D 至-4.00 D）、近视 2 组（M2 组，球镜屈光度-4.10 D 至-10.00 D）、散光 1 组（A1 组，柱镜屈光度 0 D 至-1.00 D）和散光 2 组（A2 组，柱镜屈光度-1.10 D 至-3.00 D）。进行全面评估，以检查 HOA 与各种相关因素之间的关联，包括对亚组的详细分析。
SMILE 术后，M1 组总眼彗差（CA）、角膜总高阶像差（tHOA）、内眼 tHOA 和垂直 CA（ ）均明显低于 M2 组（P＜0.05）。同样，SMILE 术后 A1 组总眼 tHOA、CA、三叶草像差（TA）、角膜 tHOA、TA 和垂直 TA（ ）均明显低于 A2 组（P＜0.05）。Pearson 相关分析表明，近视/散光的严重程度与大多数 HOA 呈显著正相关（P＜0.05）。亚组评估显示，与对照组相比，M2 组和 A2 组的近视和散光与术后 HOA 显著增加。透镜厚度、术后中央角膜厚度（CCT）、术后未矫正远视力（UDVA）和术后角膜 Km 和 Cyl 与大多数 HOA 强烈相关。年龄、眼数和术后眼压（IOP）仅与特定的 HOA 相关。
SMILE 术后 HOA 与近视和散光的严重程度呈正相关。然而，这种关系并不是线性的。SMILE 术后 HOA 受多种因素影响，需要进一步进行专门研究以确定其临床意义。
