Mengyu Wang1, Yaohua Zhang2, Wenjing Wu2,3, Joshua A Young4, Kathryn M Hatch5, Roberto Pineda5, Tobias Elze1, Yan Wang2,3. 1. Schepens Eye Research Institute, Harvard Medical School, Boston, MA, USA. 2. Tianjin Medical University, Tianjin, China. 3. Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, NanKai University, Tianjin, China. 4. Department of Ophthalmology, NYU Langone Health, New York, NY, USA. 5. Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
Abstract
PURPOSE: To investigate whether preoperative corneal topographic and biomechanical parameters (CTBPs) predict postoperative residual refractive error (RRE). METHODS: We retrospectively included 151 eyes from 151 patients of small-incision lenticule extraction (SMILE) with target RRE of plano and 3-month measurements of refractive error from Tianjin Eye Hospital. Multivariate linear/logistic regressions were performed to associate age, gender, preoperative refractive error, lenticule thickness, and CTBPs with postoperative RRE/the occurrence of myopic RRE ≤ -0.25 diopter (D). Stepwise regression was used for feature selection. Leave-one-cross-validation was used for model evaluation by the area under the receiver operating characteristic curve (AUC). RESULTS: From linear regression, more myopic RRE was associated with higher preoperative myopia, intraocular pressure (IOP), flattest curvature of anterior cornea (AC), and highest concavity deformation (HCD), and was associated with lower anterior elevation, anterior asphericity, steepest curvature of AC, and second applanation velocity. The occurrence of ≤ -0.25 D RRE was associated with higher myopia, IOP, posterior elevation and asphericity, flattest curvature of AC, first applanation velocity and HCD, and was associated with lower first applanation stiffness parameter, central corneal thickness, anterior elevation and asphericity, steepest curvature of AC, and second applanation velocity as well as thinner lenticule thickness. Compared to the baseline model using age, gender, and preoperative refractive error, adding CTBPs significantly (P < 0.001) improved the AUC performance to 0.771 from 0.615. CONCLUSIONS: Postoperative outcomes of SMILE can be predicted by individual CTBPs. TRANSLATIONAL RELEVANCE: Our findings could be used to customize a refractive nomogram based on individual corneal properties improving outcomes and patient satisfaction.
PURPOSE: To investigate whether preoperative corneal topographic and biomechanical parameters (CTBPs) predict postoperative residual refractive error (RRE). METHODS: We retrospectively included 151 eyes from 151 patients of small-incision lenticule extraction (SMILE) with target RRE of plano and 3-month measurements of refractive error from Tianjin Eye Hospital. Multivariate linear/logistic regressions were performed to associate age, gender, preoperative refractive error, lenticule thickness, and CTBPs with postoperative RRE/the occurrence of myopic RRE ≤ -0.25 diopter (D). Stepwise regression was used for feature selection. Leave-one-cross-validation was used for model evaluation by the area under the receiver operating characteristic curve (AUC). RESULTS: From linear regression, more myopic RRE was associated with higher preoperative myopia, intraocular pressure (IOP), flattest curvature of anterior cornea (AC), and highest concavity deformation (HCD), and was associated with lower anterior elevation, anterior asphericity, steepest curvature of AC, and second applanation velocity. The occurrence of ≤ -0.25 D RRE was associated with higher myopia, IOP, posterior elevation and asphericity, flattest curvature of AC, first applanation velocity and HCD, and was associated with lower first applanation stiffness parameter, central corneal thickness, anterior elevation and asphericity, steepest curvature of AC, and second applanation velocity as well as thinner lenticule thickness. Compared to the baseline model using age, gender, and preoperative refractive error, adding CTBPs significantly (P < 0.001) improved the AUC performance to 0.771 from 0.615. CONCLUSIONS: Postoperative outcomes of SMILE can be predicted by individual CTBPs. TRANSLATIONAL RELEVANCE: Our findings could be used to customize a refractive nomogram based on individual corneal properties improving outcomes and patient satisfaction.
Authors: J Bradley Randleman; Buddy Russell; Michael A Ward; Keith P Thompson; R Doyle Stulting Journal: Ophthalmology Date: 2003-02 Impact factor: 12.079
Authors: Cintia S De Paiva; Zhuo Chen; Douglas D Koch; M Bowes Hamill; Francis K Manuel; Sohela S Hassan; Kirk R Wilhelmus; Stephen C Pflugfelder Journal: Am J Ophthalmol Date: 2006-03 Impact factor: 5.258