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Vector analysis of astigmatism correction after PRK, FS-LASIK, and SMILE for myopic astigmatism

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Abstract

Purpose

To compare astigmatic correction among photorefractive keratectomy (PRK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE).

Methods

This prospective study enrolled 157 eyes that underwent three procedures (59 PRK, 47 FS-LASIK, and 51 SMILE) for the treatment of myopia with low to high astigmatism (− 0.25 to − 4.50 D). Ocular residual astigmatism (ORA) was calculated by vector analysis using refractive (RA) and corneal astigmatism. Vector analysis results were compared in different procedures in the two RA groups (low ≤ 1.00 D and high > 1.00 D) at 3 and 12 months postoperatively.

Results

There were no significant between-group differences in postoperative safety and efficacy outcomes (all P > 0.05). No significant differences were found in postoperative cylinders between all surgical groups (all p > 0.05), except for 3 months postoperative ORA in FS-LASIK (P = 0.004). At 12 months, 77%, 59.2%, and 50% of eyes attain emmetropia in the FS-LASIK, SMILE, and PRK groups, respectively.

Vector analysis showed comparable values for surgical induced astigmatism, target induced astigmatism, mean error, and angle of error between groups at 12 months. Significant differences were observed only in the correction index and difference vector parameters in the astigmatic > 1.00 D group at 3 months (P < 0.001), and FS-LASIK was preferable.

Conclusions

One-year outcomes revealed that PRK, FS-LASIK, and SMILE were all equally effective in correcting myopic astigmatism. However, FS-LASIK demonstrated more favorable astigmatism correction in eyes with astigmatism > 1.00D in early postoperatively.

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Acknowledgements

The authors received no financial support for the research, authorship, and/or publication of this article. The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran

    Hassan Hashemi

  2. Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran

    Soheila Asgari

  3. Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mehdi Khabazkhoob

  4. Department of Ophthalmology, Bu-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran; Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran

    Zahra Heidari

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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by [ZH], [HH], [MK], and [SA]. The first draft of the manuscript was written by [ZH] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zahra Heidari.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tehran University of Medical Sciences.

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Informed consent was obtained from all individual participants included.

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Hashemi, H., Asgari, S., Khabazkhoob, M. et al. Vector analysis of astigmatism correction after PRK, FS-LASIK, and SMILE for myopic astigmatism. Int Ophthalmol 43, 3999–4009 (2023). https://doi.org/10.1007/s10792-023-02804-0

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