Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors

Purpose: The purpose is to measure the decentration after small incision lenticule extraction (SMILE) in eyes with high myopia and analyze its influence factors. Methods: This retrospective study included 86 right eyes of 86 high myopia patients who underwent SMILE surgery in our hospital from Augus...

Full description

Saved in:
Bibliographic Details
Main Authors: Hui-Ni Lin, Hongqiang Zeng, Ruifeng Ji, Jinyu Li, Riping Zhang, Lixia Sun
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:https://journals.lww.com/10.4103/IJO.IJO_978_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849772619651350528
author Hui-Ni Lin
Hongqiang Zeng
Ruifeng Ji
Jinyu Li
Riping Zhang
Lixia Sun
author_facet Hui-Ni Lin
Hongqiang Zeng
Ruifeng Ji
Jinyu Li
Riping Zhang
Lixia Sun
author_sort Hui-Ni Lin
collection DOAJ
description Purpose: The purpose is to measure the decentration after small incision lenticule extraction (SMILE) in eyes with high myopia and analyze its influence factors. Methods: This retrospective study included 86 right eyes of 86 high myopia patients who underwent SMILE surgery in our hospital from August 2017 to December 2019. Patients were examined before the surgery and 3 months postoperatively. Objective and subjective refraction tests, intraocular pressure, aberrations, fundus examination, and corneal topography were recorded during all the follow-up visits. Indices of corneal anterior surface morphology, including the index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry (IHA), and index of height decentration (IHD), as well as corneal tangential curvature and kappa angle, were all collected from Pentacam (Oculus GmbH, Wetzlar, Germany). Image J software was used to measure the decentration and the area of effective optic zone (EOZ). Spearman’s correlation test and multiple linear regression analysis were performed to assess relationships between variables. Results: Overall, data from 86 eyes were gathered and analyzed. The mean age of the participants was 25.43 years (SD, 6.08; range, 18 to 45 years), and 50 eyes (58.14%) were female. The baseline refractive characteristics of the patients were summarized in Table 1. At the 3-month after SMILE, the mean UCVA (LogMAR) was −0.02 ± 0.06, and the CDVA (LogMAR) was −0.04 ± 0.05. The safety index was 1.04 ± 0.14, and the efficacy index was 0.99 ± 0.15. At the 3 months after SMILE, the horizontal decentration (HD) showed significant correlations with those preoperative indexes, including spherical aberration (SA) (r = −0.28, P < 0.05), CKI (r = 0.26, P < 0.05), and Xk (X-axis of the kappa angle) (r = 0.27, P < 0.05). The vertical decentration (VD) was significantly influenced by preoperative higher-order aberrations (HOAs) (r = 0.24, P < 0.05) and Trefoil (r = 0.39, P < 0.05) and was also positively correlated with preoperative IVA (r = 0.29, P < 0.05), IHD (r = 0.33, P < 0.05), and Yk (Y-axis of the kappa angle) (r = 0.29, P < 0.05). And the total decentration (TD) was correlated with preoperative Trefoil (r = 0.30, P < 0.05), IHD (r = 0.22, P < 0.05), and Yk (r = 0.30, P < 0.05). Multiple linear regression revealed a relationship between TD and Yk (adjust R2 = 0.18, P < 0.001). Conclusions: Patients with high myopia after SMILE had achieved effective results. A larger kappa angle especially the Yk would tend to larger decentration. High IHD and the Trefoil preoperatively also influenced the decentration after surgery.
format Article
id doaj-art-c61a7d3763114600a34c74c1db2e08ae
institution DOAJ
issn 0301-4738
1998-3689
language English
publishDate 2025-03-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Ophthalmology
spelling doaj-art-c61a7d3763114600a34c74c1db2e08ae2025-08-20T03:02:17ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-03-0173338939510.4103/IJO.IJO_978_24Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factorsHui-Ni LinHongqiang ZengRuifeng JiJinyu LiRiping ZhangLixia SunPurpose: The purpose is to measure the decentration after small incision lenticule extraction (SMILE) in eyes with high myopia and analyze its influence factors. Methods: This retrospective study included 86 right eyes of 86 high myopia patients who underwent SMILE surgery in our hospital from August 2017 to December 2019. Patients were examined before the surgery and 3 months postoperatively. Objective and subjective refraction tests, intraocular pressure, aberrations, fundus examination, and corneal topography were recorded during all the follow-up visits. Indices of corneal anterior surface morphology, including the index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry (IHA), and index of height decentration (IHD), as well as corneal tangential curvature and kappa angle, were all collected from Pentacam (Oculus GmbH, Wetzlar, Germany). Image J software was used to measure the decentration and the area of effective optic zone (EOZ). Spearman’s correlation test and multiple linear regression analysis were performed to assess relationships between variables. Results: Overall, data from 86 eyes were gathered and analyzed. The mean age of the participants was 25.43 years (SD, 6.08; range, 18 to 45 years), and 50 eyes (58.14%) were female. The baseline refractive characteristics of the patients were summarized in Table 1. At the 3-month after SMILE, the mean UCVA (LogMAR) was −0.02 ± 0.06, and the CDVA (LogMAR) was −0.04 ± 0.05. The safety index was 1.04 ± 0.14, and the efficacy index was 0.99 ± 0.15. At the 3 months after SMILE, the horizontal decentration (HD) showed significant correlations with those preoperative indexes, including spherical aberration (SA) (r = −0.28, P < 0.05), CKI (r = 0.26, P < 0.05), and Xk (X-axis of the kappa angle) (r = 0.27, P < 0.05). The vertical decentration (VD) was significantly influenced by preoperative higher-order aberrations (HOAs) (r = 0.24, P < 0.05) and Trefoil (r = 0.39, P < 0.05) and was also positively correlated with preoperative IVA (r = 0.29, P < 0.05), IHD (r = 0.33, P < 0.05), and Yk (Y-axis of the kappa angle) (r = 0.29, P < 0.05). And the total decentration (TD) was correlated with preoperative Trefoil (r = 0.30, P < 0.05), IHD (r = 0.22, P < 0.05), and Yk (r = 0.30, P < 0.05). Multiple linear regression revealed a relationship between TD and Yk (adjust R2 = 0.18, P < 0.001). Conclusions: Patients with high myopia after SMILE had achieved effective results. A larger kappa angle especially the Yk would tend to larger decentration. High IHD and the Trefoil preoperatively also influenced the decentration after surgery.https://journals.lww.com/10.4103/IJO.IJO_978_24aberrationdecentrationhigh myopiaindex of corneal anterior surface morphologysmall incision lenticule extraction (smile)
spellingShingle Hui-Ni Lin
Hongqiang Zeng
Ruifeng Ji
Jinyu Li
Riping Zhang
Lixia Sun
Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
Indian Journal of Ophthalmology
aberration
decentration
high myopia
index of corneal anterior surface morphology
small incision lenticule extraction (smile)
title Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
title_full Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
title_fullStr Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
title_full_unstemmed Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
title_short Decentration following small incision lenticule extraction (SMILE) in eyes with high myopia and its influence factors
title_sort decentration following small incision lenticule extraction smile in eyes with high myopia and its influence factors
topic aberration
decentration
high myopia
index of corneal anterior surface morphology
small incision lenticule extraction (smile)
url https://journals.lww.com/10.4103/IJO.IJO_978_24
work_keys_str_mv AT huinilin decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors
AT hongqiangzeng decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors
AT ruifengji decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors
AT jinyuli decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors
AT ripingzhang decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors
AT lixiasun decentrationfollowingsmallincisionlenticuleextractionsmileineyeswithhighmyopiaanditsinfluencefactors