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Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction
Author(s) -
Siedlecki Jakob,
Schmelter Valerie,
Schworm Benedikt,
Mayer Wolfgang J.,
Priglinger Siegfried G.,
Dirisamer Martin,
Luft Nikolaus
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14420
Subject(s) - small incision lenticule extraction , scheimpflug principle , aberrations of the eye , ophthalmology , medicine , coma (optics) , spherical aberration , corneal topography , astigmatism , optometry , visual acuity , cornea , lens (geology) , keratomileusis , physics , optics
Abstract Purpose To analyse in depth the associations between objectively measured corneal higher‐order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire. Methods This cross‐sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients’ subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances. Results A total of 394 eyes of 197 patients with a mean age of 32.4 ± 7.7 years and a mean postoperative follow‐up of 24.3 ± 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 ± 0.131 µm), coma (0.142 ± 0.179 µm), trefoil (0.018 ± 0.067 µm) as well as in total HOAs (0.191 ± 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R 2 values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164). Conclusions Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient‐reported QOV or specific long‐term visual symptoms.