Ting Shao1, Yan Wang2, Alex L K Ng3,4, Tommy C Y Chan5,6, Weiting Hao1, Jiamei Zhang2, George P M Cheng7, Vishal Jhanji8. 1. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China. 2. Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China. 3. Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, China. 4. Hong Kong Ophthalmic Associates, Hong Kong SAR, China. 5. Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China. 6. Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China. 7. The Hong Kong Laser Eye Center, Hong Kong SAR, China; and. 8. UPMC Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Abstract
PURPOSE: To compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with and without intraoperative angle kappa adjustments. METHODS: This is a retrospective case series. One hundred six eyes of 106 patients who underwent SMILE at Tianjin Eye Hospital (Tianjin Medical University, Tianjin, China) for correction of myopia and myopic astigmatism were divided into 2 groups. The first group consisted of eyes with intraoperative angle kappa adjustment and the second group consisted of eyes without adjustment. Preoperative and postoperative visual outcome, refraction, and HOA measurements at 1 and 3 months were compared. RESULTS: At the pupil size of 6 mm, vertical coma at 1 and 3 months after SMILE for the angle kappa-adjusted group was 0.153 ± 0.107 and 0.157 ± 0.094 μm, which were significantly lower than those of the nonadjusted group (0.204 ± 0.117 and 0.203 ± 0.113 μm, respectively) (P = 0.026 at 1 mo, P = 0.047 at 3 mo). The change in vertical coma between preoperative and postoperative measurements was 0.011 ± 0.136 and 0.023 ± 0.129 μm at 1 and 3 months postoperatively for the angle kappa-adjusted group, which were lower than those of the nonadjusted group (0.082 ± 0.165 and 0.085 ± 0.150 μm, respectively) (P = 0.023 at 1 mo, P = 0.045 at 3 mo). Subgroup analysis for eyes with large angle kappa demonstrated that the vertical coma was significantly less in the angle kappa-adjusted group at both 1 and 3 months (P = 0.009, P = 0.043, respectively). No significant correlation was observed between angle kappa and HOAs in the angle kappa-adjusted group. CONCLUSIONS: Adjustment of angle kappa during SMILE resulted in less HOAs. It would provide more insight on how to optimize treatment centration in SMILE.
PURPOSE: To compare higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in patients with and without intraoperative angle kappa adjustments. METHODS: This is a retrospective case series. One hundred six eyes of 106 patients who underwent SMILE at Tianjin Eye Hospital (Tianjin Medical University, Tianjin, China) for correction of myopia and myopic astigmatism were divided into 2 groups. The first group consisted of eyes with intraoperative angle kappa adjustment and the second group consisted of eyes without adjustment. Preoperative and postoperative visual outcome, refraction, and HOA measurements at 1 and 3 months were compared. RESULTS: At the pupil size of 6 mm, vertical coma at 1 and 3 months after SMILE for the angle kappa-adjusted group was 0.153 ± 0.107 and 0.157 ± 0.094 μm, which were significantly lower than those of the nonadjusted group (0.204 ± 0.117 and 0.203 ± 0.113 μm, respectively) (P = 0.026 at 1 mo, P = 0.047 at 3 mo). The change in vertical coma between preoperative and postoperative measurements was 0.011 ± 0.136 and 0.023 ± 0.129 μm at 1 and 3 months postoperatively for the angle kappa-adjusted group, which were lower than those of the nonadjusted group (0.082 ± 0.165 and 0.085 ± 0.150 μm, respectively) (P = 0.023 at 1 mo, P = 0.045 at 3 mo). Subgroup analysis for eyes with large angle kappa demonstrated that the vertical coma was significantly less in the angle kappa-adjusted group at both 1 and 3 months (P = 0.009, P = 0.043, respectively). No significant correlation was observed between angle kappa and HOAs in the angle kappa-adjusted group. CONCLUSIONS: Adjustment of angle kappa during SMILE resulted in less HOAs. It would provide more insight on how to optimize treatment centration in SMILE.