Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis

Abstract Purpose We evaluated the efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation for correcting myopia with high astigmatism by vector analysis. Methods This retrospective...

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Main Authors: Xiaohang Jiao, Wenxin Xue, Ziyu Zhou, Jing Yang, Weiqun Wang, Yanhui Bai
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04209-2
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author Xiaohang Jiao
Wenxin Xue
Ziyu Zhou
Jing Yang
Weiqun Wang
Yanhui Bai
author_facet Xiaohang Jiao
Wenxin Xue
Ziyu Zhou
Jing Yang
Weiqun Wang
Yanhui Bai
author_sort Xiaohang Jiao
collection DOAJ
description Abstract Purpose We evaluated the efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation for correcting myopia with high astigmatism by vector analysis. Methods This retrospective study included 155 patients (155 eyes) with myopia and high astigmatism who underwent SMILE, FS-LASIK, or TICL implantation at our hospital. Patients were selected and divided into three groups based on the surgical procedure. The safety and effectiveness of three methods in correcting high astigmatism were compared, and the efficacy on high astigmatism were compared using Alpins’ vector analysis. Results Six months after surgery, operative safety and effectiveness did not differ significantly among the implantation types. Postoperative cylinder and SE were higher in the SMILE and FS-LASIK groups compared to the TICL group (P < 0.05). Among the three groups, significant differences were observed in surgically-induced astigmatism (1.91 ± 0.46D vs. 2.14 ± 0.56D vs. 1.89 ± 0.63D), difference vector (0.43 ± 0.28 vs. 0.34 ± 0.24 vs. 0.80 ± 0.52), correction index (0.96 ± 0.15 vs. 1.02 ± 0.15 vs. 0.87 ± 0.21), angle of error (-3.38 ± 5.87°vs. -0.54 ± 4.04° vs. -7.23 ± 10.09°), flattening effect (1.87 ± 0.47 vs. 2.13 ± 0.57 vs. 1.74 ± 0.64), flattening index (0.93 ± 0.14 vs. 1.01 ± 0.15 vs. 0.80 ± 0.22), and index of success (0.23 ± 0.16 vs. 0.16 ± 0.12 vs. 0.38 ± 0.24) (P < 0.05). Conclusions SMILE, FS-LASIK, and TICL implantation are all safe and effective for correcting myopia with high astigmatism. FS-LASIK demonstrated the best correction effect on high astigmatism, followed by SMILE and TICL implantation.
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spelling doaj-art-c62c4edbc84841c394ab8197e524bcdf2025-08-20T04:01:24ZengBMCBMC Ophthalmology1471-24152025-07-0125111210.1186/s12886-025-04209-2Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysisXiaohang Jiao0Wenxin Xue1Ziyu Zhou2Jing Yang3Weiqun Wang4Yanhui Bai5The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityAbstract Purpose We evaluated the efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation for correcting myopia with high astigmatism by vector analysis. Methods This retrospective study included 155 patients (155 eyes) with myopia and high astigmatism who underwent SMILE, FS-LASIK, or TICL implantation at our hospital. Patients were selected and divided into three groups based on the surgical procedure. The safety and effectiveness of three methods in correcting high astigmatism were compared, and the efficacy on high astigmatism were compared using Alpins’ vector analysis. Results Six months after surgery, operative safety and effectiveness did not differ significantly among the implantation types. Postoperative cylinder and SE were higher in the SMILE and FS-LASIK groups compared to the TICL group (P < 0.05). Among the three groups, significant differences were observed in surgically-induced astigmatism (1.91 ± 0.46D vs. 2.14 ± 0.56D vs. 1.89 ± 0.63D), difference vector (0.43 ± 0.28 vs. 0.34 ± 0.24 vs. 0.80 ± 0.52), correction index (0.96 ± 0.15 vs. 1.02 ± 0.15 vs. 0.87 ± 0.21), angle of error (-3.38 ± 5.87°vs. -0.54 ± 4.04° vs. -7.23 ± 10.09°), flattening effect (1.87 ± 0.47 vs. 2.13 ± 0.57 vs. 1.74 ± 0.64), flattening index (0.93 ± 0.14 vs. 1.01 ± 0.15 vs. 0.80 ± 0.22), and index of success (0.23 ± 0.16 vs. 0.16 ± 0.12 vs. 0.38 ± 0.24) (P < 0.05). Conclusions SMILE, FS-LASIK, and TICL implantation are all safe and effective for correcting myopia with high astigmatism. FS-LASIK demonstrated the best correction effect on high astigmatism, followed by SMILE and TICL implantation.https://doi.org/10.1186/s12886-025-04209-2SMILEFS-LASIKTICLHigh astigmatismVector analysisAlpins method
spellingShingle Xiaohang Jiao
Wenxin Xue
Ziyu Zhou
Jing Yang
Weiqun Wang
Yanhui Bai
Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
BMC Ophthalmology
SMILE
FS-LASIK
TICL
High astigmatism
Vector analysis
Alpins method
title Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
title_full Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
title_fullStr Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
title_full_unstemmed Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
title_short Efficacy of small incision lenticule extraction (SMILE), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and toric implantable collamer lens (TICL) implantation in correcting myopia with high astigmatism: a vector analysis
title_sort efficacy of small incision lenticule extraction smile femtosecond assisted laser in situ keratomileusis fs lasik and toric implantable collamer lens ticl implantation in correcting myopia with high astigmatism a vector analysis
topic SMILE
FS-LASIK
TICL
High astigmatism
Vector analysis
Alpins method
url https://doi.org/10.1186/s12886-025-04209-2
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