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Jesus Noel Jaurrieta-Hinojos, Oscar Fernandez; Changes in visual acuity and high-order aberrations after SMILE. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4884. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analize high-order aberrations (HOA) before and 1 week, 1 month and 3 months after Small Incision Lenticule Extraction (SMILE) refractive surgery.To quantify the change in uncorrected visual acuity (UCVA) after SMILE.
Prospective, analytic, observational study design done from January 1st until September 1st 2015. We analyzed logMAR UCVA, and the root mean square (RMS) of several HOA including: comma, trefoil, spherical aberration, defocus and astigmatism using a Hartmann-Shack aberrometer (WaveScan, VisX®). All these measurements were done before SMILE and 1 week, 1 month and 3 months afterwards. SMILE surgery was realized using an Visumax 500 kHz (Carl Zeiss Meditec®) femtosecond laser. All data was emptied to an Excel data sheet and statistical analysis was done using SPSS 21 (IBM®). Student's t was used to compare HOA before and after surgery and Pearson's test was used to assess the correlation between the study's variables.
71 eyes of 37 patients were included. Mean age at first visit was 28 years. An increase in HOA RMS was found after surgery at all time points evaluated (p<0.05). There was a decrease in defocus, astigmatism and UCVA logMAR (p<0.05). Both trefoil and spherical aberration were not statistically significant modified. We found a positive correlation between the degree in astigmatism with the flap diameter (r=0.661, p<0.0001) and with the optical zone (r=0.661, p=0.000007). A negative correlation was found between UCVA logMAR and HOA RMS and spherical aberration (p=0.044 and p=0.004, respectively).
SMILE surgery entailed an statistically significant increase in HOA RMS, coma and a decrease in defocus and astigmatism at a week, 1 month and 3 months postoperatively. All included patients in this study achieved an UCVA logMAR of 0.09 or better at 3 months. We believe that SMILE is an efficient refractive technique with a mild induction of HOA RMS and comma after surgery that mantains stable at least after 3 months.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Figure 2 - Individual HOA before surgery, 1 week, 1 month and 3 months postoperatively
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