Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery

PurposeThis study aimed to evaluate changes in visual quality among myopic patients with varying tear film stability after small incision lenticule extraction (SMILE) using the Optical Quality Analysis System (OQAS II).MethodsThis prospective study analyzed 141 patients who underwent SMILE surgery,...

Full description

Saved in:
Bibliographic Details
Main Authors: Tao Liao, Lili Li, Diefeng Wei, Hejuan Mao, Yanyan Huang, Pengfei Lu, Dedong Zhong, Haiyan Lu, Huiyao Huang, Qi Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1538359/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849712373094416384
author Tao Liao
Tao Liao
Lili Li
Diefeng Wei
Hejuan Mao
Yanyan Huang
Pengfei Lu
Dedong Zhong
Haiyan Lu
Huiyao Huang
Qi Chen
author_facet Tao Liao
Tao Liao
Lili Li
Diefeng Wei
Hejuan Mao
Yanyan Huang
Pengfei Lu
Dedong Zhong
Haiyan Lu
Huiyao Huang
Qi Chen
author_sort Tao Liao
collection DOAJ
description PurposeThis study aimed to evaluate changes in visual quality among myopic patients with varying tear film stability after small incision lenticule extraction (SMILE) using the Optical Quality Analysis System (OQAS II).MethodsThis prospective study analyzed 141 patients who underwent SMILE surgery, selecting the right eye of each patient for analysis. Objective visual quality and tear film stability were assessed using the OQAS II preoperatively and at 1 week, 1 month, and 3 months postoperatively. Refractive error and uncorrected visual acuity were measured at the same time points. At the 1-week follow-up, all patients completed a visual quality questionnaire and underwent tear film break-up time (TBUT) measurement. These assessments were conducted to evaluate the correlation between subjective visual perception and objective visual quality, as well as to examine the relationship between the two methods of tear film evaluation.ResultsNo significant differences in UDVA or postoperative spherical and equivalent spherical values were observed between groups at any postoperative time point (p > 0.05). At 1 week and 1 month post-surgery, both groups exhibited elevated Objective Scatter Index (OSI) and Mean OSI values, while OV100%, OV20%, OV9%, MTF cutoff, and Strehl ratio (SR) decreased compared to preoperative levels (all p < 0.05). By 3 months post-surgery, all objective visual quality parameters in the tear film stability group returned to preoperative levels (p > 0.05). In contrast, in the instability group, only SR remained unchanged, while other parameters significantly differed from baseline (p < 0.05). Positive correlations were found between OSI values and both foggy vision and glare at 1 week postoperatively in both groups. TF-OSI values positively correlated with blinking frequency and visual fluctuations. OV100% values at all preoperative and postoperative time points did not effectively predict subjective visual acuity.ConclusionTear film instability negatively impacts visual quality recovery and prolongs corneal healing time after SMILE surgery. However, it does not cause short-term refractive regression. OV100% shows limited predictive ability for visual acuity. A significant correlation exists between objective visual quality and subjective perception. The OQAS II system is a valuable tool for assessing tear film stability and objective visual quality in refractive surgery patients.
format Article
id doaj-art-2f4ed15b389c4a90a2ca917898bcf5f2
institution DOAJ
issn 2296-858X
language English
publishDate 2025-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-2f4ed15b389c4a90a2ca917898bcf5f22025-08-20T03:14:17ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15383591538359Evaluation of changes in objective visual quality based on tear film stability after SMILE surgeryTao Liao0Tao Liao1Lili Li2Diefeng Wei3Hejuan Mao4Yanyan Huang5Pengfei Lu6Dedong Zhong7Haiyan Lu8Huiyao Huang9Qi Chen10Visual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaGuangxi Medical University, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaVisual Science and Optometry Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Key Laboratory of Eye Health, Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology, Institute of Ophthalmic Diseases, Guangxi Academy of Medical Sciences, Nanning, ChinaPurposeThis study aimed to evaluate changes in visual quality among myopic patients with varying tear film stability after small incision lenticule extraction (SMILE) using the Optical Quality Analysis System (OQAS II).MethodsThis prospective study analyzed 141 patients who underwent SMILE surgery, selecting the right eye of each patient for analysis. Objective visual quality and tear film stability were assessed using the OQAS II preoperatively and at 1 week, 1 month, and 3 months postoperatively. Refractive error and uncorrected visual acuity were measured at the same time points. At the 1-week follow-up, all patients completed a visual quality questionnaire and underwent tear film break-up time (TBUT) measurement. These assessments were conducted to evaluate the correlation between subjective visual perception and objective visual quality, as well as to examine the relationship between the two methods of tear film evaluation.ResultsNo significant differences in UDVA or postoperative spherical and equivalent spherical values were observed between groups at any postoperative time point (p > 0.05). At 1 week and 1 month post-surgery, both groups exhibited elevated Objective Scatter Index (OSI) and Mean OSI values, while OV100%, OV20%, OV9%, MTF cutoff, and Strehl ratio (SR) decreased compared to preoperative levels (all p < 0.05). By 3 months post-surgery, all objective visual quality parameters in the tear film stability group returned to preoperative levels (p > 0.05). In contrast, in the instability group, only SR remained unchanged, while other parameters significantly differed from baseline (p < 0.05). Positive correlations were found between OSI values and both foggy vision and glare at 1 week postoperatively in both groups. TF-OSI values positively correlated with blinking frequency and visual fluctuations. OV100% values at all preoperative and postoperative time points did not effectively predict subjective visual acuity.ConclusionTear film instability negatively impacts visual quality recovery and prolongs corneal healing time after SMILE surgery. However, it does not cause short-term refractive regression. OV100% shows limited predictive ability for visual acuity. A significant correlation exists between objective visual quality and subjective perception. The OQAS II system is a valuable tool for assessing tear film stability and objective visual quality in refractive surgery patients.https://www.frontiersin.org/articles/10.3389/fmed.2025.1538359/fullSMILEobjective visual qualityOQAS IIdry eyetear film stability
spellingShingle Tao Liao
Tao Liao
Lili Li
Diefeng Wei
Hejuan Mao
Yanyan Huang
Pengfei Lu
Dedong Zhong
Haiyan Lu
Huiyao Huang
Qi Chen
Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
Frontiers in Medicine
SMILE
objective visual quality
OQAS II
dry eye
tear film stability
title Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
title_full Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
title_fullStr Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
title_full_unstemmed Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
title_short Evaluation of changes in objective visual quality based on tear film stability after SMILE surgery
title_sort evaluation of changes in objective visual quality based on tear film stability after smile surgery
topic SMILE
objective visual quality
OQAS II
dry eye
tear film stability
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1538359/full
work_keys_str_mv AT taoliao evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT taoliao evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT lilili evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT diefengwei evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT hejuanmao evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT yanyanhuang evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT pengfeilu evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT dedongzhong evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT haiyanlu evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT huiyaohuang evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery
AT qichen evaluationofchangesinobjectivevisualqualitybasedontearfilmstabilityaftersmilesurgery