Deng Manli, Zhou Dan, Li Min, Shi Yuehui, Sun Lina, Zou Jun, Ma Xiaoyun
Department of Ophthalmology, Shanghai University of Medicine & Health Science Affiliated Zhou Pu Hospital, 1500 Zhouyuan Road, Shanghai, 201318, China.
Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, 301 Yan Chang Middle Road, Shanghai, 200072, China.
Int Ophthalmol. 2025 Jun 1;45(1):218. doi: 10.1007/s10792-025-03576-5.
To evaluate the relationships between the magnitudes of corneal asymmetry and induced ocular higher-order aberrations (HOAs) after small-incision lenticule extraction (SMILE) for moderate-to-high myopia.
Sixty-six eyes of 66 patients who underwent SMILE were divided into two groups: the high (SE ≥ -6.0 D, n = 27, Group H) and moderate (- 3.0 D ≤ SE < - 6.0 D, n = 39, Group M) myopia groups. Using Fourier harmonic analysis, the spherical component (SC), regular astigmatism (RA), asymmetry, and higher-order irregularity (HOI) were obtained from videokeratography data. Visual acuity, manifest refraction, and ocular HOAs were assessed at baseline and 3, 6, and 12 months postoperatively. The relationships between Fourier components and ocular HOAs were assessed.
In both groups, vertical coma, horizontal coma, spherical aberration, total higher-order aberrations (tHOAs), and asymmetry of the anterior corneal surface increased postoperatively (from 3 to 12 months), while SC and RA of the anterior corneal surface decreased (all P < 0.05). More vertical coma and asymmetry of the anterior corneal surface were induced in Group H than in Group M at 3 and 6 months postoperatively (all P < 0.05). The association between preoperative asymmetry of the anterior corneal surface and preoperative spherical aberration was significant in both groups (R = 0.138, P = 0.02; R = 0.172, P = 0.032, respectively). The asymmetry of the anterior corneal surface was correlated with vertical coma, spherical aberration, and tHOAs at 3, 6, and 12 months postoperatively in both groups (all R > 0.2, all P < 0.05).
The visual quality after SMILE was associated with the asymmetry of the anterior corneal surface for moderate and high myopia.
评估中高度近视患者行小切口透镜切除术（SMILE）后角膜不对称程度与诱发的眼高阶像差（HOAs）之间的关系。
66例行SMILE手术的患者的66只眼被分为两组：高度近视组（SE≥ -6.0 D，n = 27，H组）和中度近视组（-3.0 D≤SE＜-6.0 D，n = 39，M组）。使用傅里叶谐波分析，从角膜地形图数据中获取球镜成分（SC）、规则散光（RA）、不对称性和高阶不规则性（HOI）。在基线以及术后3、6和12个月评估视力、显验光和眼HOAs。评估傅里叶成分与眼HOAs之间的关系。
两组患者术后（3至12个月）垂直彗差、水平彗差、球差、总高阶像差（tHOAs）和角膜前表面不对称性均增加，而角膜前表面的SC和RA降低（所有P＜0.05）。术后3个月和6个月时，H组比M组诱发了更多的垂直彗差和角膜前表面不对称性（所有P＜0.05）。两组患者术前角膜前表面不对称性与术前球差之间的相关性均显著（分别为R = 0.138，P = 0.02；R = 0.172，P = 0.032）。两组患者术后3、6和12个月时，角膜前表面不对称性与垂直彗差、球差和tHOAs均相关（所有R＞0.2，所有P＜0.05）。
对于中高度近视，SMILE术后的视觉质量与角膜前表面不对称性有关。
