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The effects of programmed optical zones on achieved corneal refractive power with myopic astigmatism after small incision lenticule extraction (SMILE): a vector analysis

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Abstract

Purpose

To evaluate the effects of different programmed optical zones (POZs) on achieved corneal refractive power (CRP) with myopic astigmatism after small incision lenticule extraction (SMILE).

Methods

In total, 113 patients (113 eyes) were included in this retrospective study. The eyes were divided into two groups according to POZ: group A (6.5, 6.6, and 6.7 mm, n = 59) and group B (6.8, 6.9, and 7.0 mm, n = 54). Fourier vector analysis was applied to evaluate the error values between the attempted and achieved corneal refractive power (CRP). Alpins vector analysis was used to calculate surgically induced astigmatism (SIA), difference vector (DV), magnitude of error (ME), and astigmatism correction index (ACI). Multivariate regression analysis was performed to assess potential factors associated with the error values.

Results

The error values in the group with large POZ were closer to zero, and significantly associated with the POZ at 2 and 4 mm of the cornea (β =  − 0.50, 95% confidence interval [CI] [− 0.80, − 0.20]; β =  − 0.37, 95% CI [− 0.63, − 0.10], P < 0.05, respectively). For the correction of astigmatism, the values of SIA, ME, and ACI were lower in group B than in group A (P < 0.05). The fitting curves between TIA and SIA were y = 0.83x + 0.19 (R2 = 0.84) and y = 1.05x + 0.04 (R2 = 0.90), respectively.

Conclusions

Smaller POZs resulted in higher error values between the achieved- and attempted-CRP in the SMILE procedure, which should be considered when performing surgery.

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Acknowledgements

The authors gratefully acknowledge the funding support from the National Natural Science Foundation of China and the Key Projects of Science and Technology Fund of Tianjin Health and Family Planning Commission.

Funding

This work was supported by the National Program on Key Research Project of China (YW:2022YFC2404505), the Tianjin Diversified Investment Fund for Applied Basic Research (YW: 21JCZDJC01190), the Tianjin Health and Technology Project (YW: TJWJ2022XK036), the Key Projects of Science and Technology Fund of Tianjin Health and Family Planning Commission (QF: 2014KR17), and the Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-016A).

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Author notes

  1. Haohan Zou and Xinheng Zhao are contributed equally to the study as the first authors.

Authors and Affiliations

  1. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China

    Haohan Zou

  2. Clinical College of Ophthalmology, Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Medical University, No 4. Gansu Road, He-Ping District, Tianjin, 300020, China

    Haohan Zou, Xinheng Zhao, Jiamei Zhang, Lulu Xu, Qian Fan, Lin Zhang & Yan Wang

  3. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China

    Tommy C. Y. Chan

  4. Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China

    Tommy C. Y. Chan

  5. Nankai University Eye Institute, Nankai University affiliated Eye Hospital, Nankai University, Tianjin, China

    Yan Wang

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Contributions

The corresponding author, Professor Yan Wang, contributed to the conception and design. Material preparation, data collection, and analysis were performed by HZ and XZ. The first draft of the manuscript was written by HZ and XZ. LX, JZ, QF, and LZ commented on previous versions of the manuscript. YW and TCYC revised and approved the final manuscript.

Corresponding author

Correspondence to Yan Wang.

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Conflict of interest

Haohan Zou, Xinheng Zhao, Lulu Xu, Jiamei Zhang, Qian Fan, Lin Zhang, Tommy C.Y. Chan, and Yan Wang declare that they have no competing interests. There are no competing interests regarding the equipment used in this study.

Ethical approval

This study was registered in the Clinical Trial Register (NCT05017376), approved by the Ethics Committee of Tianjin Eye Hospital, and conducted in accordance with the Declaration of Helsinki.

Consent to participate

The ethics committee waived the requirement for informed consent, given the retrospective nature of data collection and the use of anonymized data.

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Zou, H., Zhao, X., Zhang, J. et al. The effects of programmed optical zones on achieved corneal refractive power with myopic astigmatism after small incision lenticule extraction (SMILE): a vector analysis. Int Ophthalmol 43, 2493–2501 (2023). https://doi.org/10.1007/s10792-023-02649-7

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  • DOI: https://doi.org/10.1007/s10792-023-02649-7

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