Meng Xuyun, Ding Hui, Yang Zhenduo, Chen Xiaodan, Hu Shisi, Zhong Xingwu
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, 510060, China.
Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Hainan Eye Hospital, Sun Yat-sen University, Haikou, 570300, China.
BMC Ophthalmol. 2025 Mar 11;25(1):121. doi: 10.1186/s12886-025-03948-6.
To compare the refractive outcomes and visual quality among different types of astigmatism following SMILE and evaluate effective optical zone (EOZ) features, decentration and their potential effects on visual quality.
This study included 101 left eyes of 101 patients who underwent SMILE. Patients were grouped according to astigmatism types (with-the-rule [WTR], against-the-rule [ATR] and oblique astigmatism) and decentered displacement (major axis > minor axis and major axis < minor axis). We compared the refractive outcomes, visual quality, EOZ and decentration 3 months postoperatively and analyzed correlations between corneal aberrations and EOZ parameters.
The visual and refractive outcomes were favorable in different types of astigmatism. The induced corneal aberrations, EOZ and total decentration were comparable among three groups (all p >.05). There was a strong positive correlation (r =.828, p <.001) between preoperative cylinder axis and the angle of EOZ. The postoperative induced changes in spherical aberration (0.02 ± 0.15 vs. 0.08 ± 0.13, p =.037), coma (0.22 ± 0.27 vs. 0.36 ± 0.25, p =.010), total HOAs (0.28 ± 0.24 vs. 0.42 ± 0.31, p =.009) and LOAs (0.16 ± 0.62 vs. 0.49 ± 0.84, p =.023) were fewer in group with greater decentered displacement along the major axis than the minor axis.
Favorable outcomes were observed in different types of astigmatism. Postoperative refractive errors, visual acuity, and induced corneal aberrations showed no significant differences between groups with WTR, ATR, and oblique astigmatism. The angle of EOZ was closely associated with cylinder axis. EOZ provided greater tolerance to decentration, with fewer induced corneal aberrations along the major axis compared to the minor axis. The combined impacts of EOZ and decentration on visual quality should be noted.
比较小切口基质透镜切除术（SMILE）后不同类型散光的屈光效果和视觉质量，并评估有效光学区（EOZ）特征、偏心情况及其对视觉质量的潜在影响。
本研究纳入了101例行SMILE手术的患者的101只左眼。根据散光类型（顺规散光[WTR]、逆规散光[ATR]和斜向散光）和偏心移位（长轴＞短轴和长轴＜短轴）对患者进行分组。我们比较了术后3个月的屈光效果、视觉质量、EOZ和偏心情况，并分析了角膜像差与EOZ参数之间的相关性。
不同类型散光的视觉和屈光效果良好。三组之间诱导的角膜像差、EOZ和总偏心量相当（所有p＞0.05）。术前柱镜轴与EOZ角度之间存在强正相关（r = 0.828，p＜0.001）。长轴方向偏心移位大于短轴方向的组，术后诱导的球差变化（0.02±0.15 vs. 0.08±0.13，p = 0.037）、彗差（0.22±0.27 vs. 0.36±0.25，p = 0.010）、总高阶像差（0.28±0.24 vs. 0.42±0.31，p = 0.009）和低阶像差（0.16±0.62 vs. 0.49±0.84，p = 0.023）更少。
不同类型散光均观察到良好的效果。WTR、ATR和斜向散光组之间术后屈光不正、视力和诱导的角膜像差无显著差异。EOZ角度与柱镜轴密切相关。EOZ对偏心具有更大的耐受性，与短轴相比，长轴方向诱导的角膜像差更少。应注意EOZ和偏心对视觉质量的综合影响。
