July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Predicting Undercorrection of Myopia After Small Incision Lenticule Extraction using Corneal Topographic and Biomechanical Properties
Author Affiliations & Notes
  • Yan Wang
    Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, NanKai University, Tianjin, China
    Tianjin Medical University, Tianjin, China
  • Yaohua Zhang
    Tianjin Medical University, Tianjin, China
  • Wenjing Wu
    Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, NanKai University, Tianjin, China
    Tianjin Medical University, Tianjin, China
  • Joshua A Young
    Department of Ophthalmology, NYU Langone Health, New York, New York, United States
  • Kathryn M Hatch
    Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Ula V. Jurkunas
    Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Roberto Pineda II
    Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Tobias Elze
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
  • Mengyu Wang
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Yan Wang, None; Yaohua Zhang, None; Wenjing Wu, None; Joshua A Young, None; Kathryn M Hatch, Avedro (C), Checked up (C), Johnson & Johnson (C), Shire (C); Ula Jurkunas, None; Roberto Pineda II, Amgen (C), Beaver Visitec International (C), Elsiever (F), Sanofi/ Genzyme (C); Tobias Elze, None; Mengyu Wang, None
  • Footnotes
    Support  National Natural Science Foundation of China (Grants No. 81670884); NEI Core Grant P30EYE003790
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5769. doi:
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      Yan Wang, Yaohua Zhang, Wenjing Wu, Joshua A Young, Kathryn M Hatch, Ula V. Jurkunas, Roberto Pineda II, Tobias Elze, Mengyu Wang; Predicting Undercorrection of Myopia After Small Incision Lenticule Extraction using Corneal Topographic and Biomechanical Properties. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5769.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The steeper corneal curvature and increasing age have been associated with undercorrection of myopia after Small Incision Lenticule Extraction (SMILE) [1]. In this study, we aim to systematically investigate the relationship between preoperative corneal topographic and biomechanical properties (CTBPs) and undercorrection of myopia after SMILE surgery.

Methods : From Tianjin Eye Hospital, we selected eyes that had SMILE surgeries with expected postoperative refractive error of zero and 3 months follow-up measurements of refractive error. Preoperative CTBPs measured by Pentacam and OCULUS Corvis ST were extracted. The occurrence of undercorrection was mathematically defined as postoperative spherical equivalent (SE) less than zero. Logistic regression with stepwise model selection was applied to model the relationship between the undercorrection of myopia and preoperative CTBPs combining with age, gender and preoperative refractive error. Cross validation was used to evaluate the model on testing data by the area under the receiver operating characteristic curve (AUC).

Results : 179 eyes from 105 patients including 58 male and 47 female were selected for analyses. 44 eyes were undercorrected. The mean ± standard deviation of age was 22.3±5.5 years. Fig. 1 (a) and (b) show the distributions of preoperative SE (-5.4±1.7 diopters) and postoperative SE (-0.03±0.2 diopters), respectively. The higher preoperative refractive error was significantly associated with (r=0.29, p<0.001) more undercorrected postoperative SE. Fig. 2 (a) shows that the occurrence of undercorrection of myopia was associated with smaller stiffness at first applanation and sphere, and higher IOP, velocity at second applanation and highest concavity deformation in the best predictive model. The AUC performance by cross validation was 0.748 (95% confidence interval (CI): 0.737−0.759), which was significantly higher (p<0.001) than the AUC of the model only using sphere as predictor: 0.642 (95% CI: 0.636−0.647).

Conclusions : Higher preoperative myopia was correlated to more undercorrected postoperative SE. Weaker preoperative corneal biomechanical properties contribute to the occurrence of undercorrection of myopia, which might be related to corneal remodeling. Our model can be potentially used to improve the precision of refractive surgery.

[1] Hjortdal et al., 2012, J. Refract. Surg.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

 

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