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Subjective patient-reported visual quality after small-incision lenticule extraction and its correlation to the objective one

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Abstract

Purpose

The purpose of the study was to characterize the subjective visual quality and satisfaction following small-incision lenticule extraction (SMILE) and to identify its influential factors.

Setting

Peking University Third Hospital, Beijing, China.

Design

This was a retrospective observational study.

Methods

Patients who had simultaneous binocular SMILE for myopia and myopic astigmatism were included 6 months postoperatively, and the patient-reported outcome questionnaire was employed for the assessment of visual quality in real-life situations. Examinations with SIRIUS combined corneal topography and tomography were performed including the parameters of Strehl ratio (SR), corneal higher-order aberrations (HOAs) within 6.0-mm area, kappa angel, and thinnest corneal thickness. Decentration and effective optical zone (EOZ) were measured based on a tangential pre–post-operation difference map. Binary logistic regression analysis was performed for predictors of patient-reported visual quality.

Results

Clinical data from 97 cases were analyzed retrospectively. Overall satisfaction was 96.91% (94/97). Fluctuation in vision and glare is the most frequent and dominant visual symptoms. SR value increased non-significantly compared with preoperative (P> 0.05). A statistically significant (P < 0.05) increase in total HOAs, spherical aberration, and coma was noted. SR and HOAs were not correlated with the degree of visual symptoms (P > 0.05). No objective parameter was found to be associated with patient-reported visual quality after SMILE (P> 0.05).

Conclusion

The high patient-reported satisfaction confirmed the ideal effect on visual quality following SMILE in real-life situations, though some objective optical performances were not satisfying. It is very tolerant toward patients’ conditions and mild deviations, and this study did not find factors affecting visual performances.

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Data availability

All analysis-based data generated in the study have been included in the manuscript or in the supplementary material. Additional requests for data can be directed to the corresponding author.

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Funding

This work was supported by a grant from the Key Clinical Innovation Program of Peking University Third Hospital, Category A (grant no. Y65495-05).

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Authors and Affiliations

  1. Department of Ophthalmology, Peking University Third Hospital, No 49 Huayuan North Road, Haidian District, Beijing, 100191, China

    Ruiyu Zhang, Yifei Yuan, Yu Zhang & Yueguo Chen

  2. Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Institute of Laser Medicine, Beijing, China

    Ruiyu Zhang, Yifei Yuan, Yu Zhang & Yueguo Chen

Authors
  1. Ruiyu Zhang
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  2. Yifei Yuan
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  3. Yu Zhang
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  4. Yueguo Chen
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Contributions

Ruiyu Zhang and Yifei Yuan wrote the main manuscript text and Yu Zhang prepared Tables. All authors reviewed the manuscript.

Corresponding author

Correspondence to Yueguo Chen.

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Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licencing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Consent to participate

Informed consent was obtained from all participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Peking University Third Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Zhang, R., Yuan, Y., Zhang, Y. et al. Subjective patient-reported visual quality after small-incision lenticule extraction and its correlation to the objective one. Int Ophthalmol 43, 3935–3942 (2023). https://doi.org/10.1007/s10792-023-02794-z

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  • DOI: https://doi.org/10.1007/s10792-023-02794-z

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