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Background  The early visual qualities of patients with moderate myopia were evaluated after small incision lenticule extraction (SMILE) using different optical zones.    Methods  In this retrospective case study, 27 cases (51 eyes) were selected, including 10 cases in Group A (19 eyes), 6.6–6.8 mm in the optical zone, 10 cases in Group B (19 eyes), 6.4–6.5 mm in the optical zone, and 7 cases in Group C (13 eyes),6.1–6.3 mm in the optical zone. The following items were examined preoperatively and 1 month postoperatively: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical, cylinder, central corneal thickness (CCT), corneal mean curvature (CMC), total ocular aberrations (TA), total low order aberrations (tLOAs), defocus, astigmatism and total high order aberrations (tHOAs), spherical, coma, trefoil, modulation transfer function (MTF), MTF cutoff , SR, objective scatter index (OSI), point scatter function at 50 and 10% (PSF50%, PSF10%), and contrast visual acuity of 100, 20, and 9% (VA100%, VA20%, and VA9%). We compared the three groups by Kruskal-Wallis test. Wilcoxon signed ranks test was used for each group before and 1 month after surgeries.  P < 0.05 was considered statistically significant.    Results  There was no significant difference in UCVA, BCVA, CCT, cylinder, and CMC in three groups preoperatively and 1 month postoperatively ( P > 0.05). Comparison of the aberrations of the three groups showed statistically significant difference only in TA, tLOA, defocus, astigmatism and SA preoperatively, and trefoil 1 month postoperatively( P < 0.05). The postoperative TA, tLOAs, defocus, astigmatism and trefoil of the three groups were lower than those before surgeries ( P < 0.05). The postoperative tHOAs of Group B and C was lower than those before surgeries ( P < 0.05). The MTF results showed that before surgeries, there were significant differences in three groups ( P < 0.05) in spatial frequencies 5~15 cycles per degree (cpd), and no differences in 20~30 cpd( P > 0.05), while no difference were observed in all spatial frequencies postoperatively ( P > 0.05). Comparing the preoperative and postoperative MTF values for each group, the results showed that there was a significant difference in Group C at 5~20 cpd after surgeries( P < 0.05). There was no significant difference in MTF cutoff , SR, OSI, PSF50%, PSF10%, VA100%, VA20%, and VA9% in the three groups preoperatively ( P > 0.05). One month after surgeries, higher VA9% values were measured for Group C compared to Group A and B ( P  < 0.05). There was no significant difference in each group before and after surgeries ( P > 0.05).    Conclusion  SMILE could improve the visual qualities of patients with moderate myopia. Reducing the surgical optical zone will only affect night vision slightly.

Comparison of early visual quality in patients with moderate myopia using different optical zones in small incision lenticule extraction (SMILE)