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Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)

Little is known about the connection between preoperative keratometry and postoperative results of myopic small-incision lenticule extraction (SMILE). To determine the influence of extreme (flat and steep) corneal keratometry on the safety and efficacy of SMILE, the databases of the Department of Op...

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Autores principales: Luft, Nikolaus, Siedlecki, Jakob, Reinking, Franziska, Mayer, Wolfgang J., Schworm, Benedikt, Kassumeh, Stefan, Priglinger, Siegfried G., Dirisamer, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426392/
https://www.ncbi.nlm.nih.gov/pubmed/34497302
http://dx.doi.org/10.1038/s41598-021-97375-4
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author Luft, Nikolaus
Siedlecki, Jakob
Reinking, Franziska
Mayer, Wolfgang J.
Schworm, Benedikt
Kassumeh, Stefan
Priglinger, Siegfried G.
Dirisamer, Martin
author_facet Luft, Nikolaus
Siedlecki, Jakob
Reinking, Franziska
Mayer, Wolfgang J.
Schworm, Benedikt
Kassumeh, Stefan
Priglinger, Siegfried G.
Dirisamer, Martin
author_sort Luft, Nikolaus
collection PubMed
description Little is known about the connection between preoperative keratometry and postoperative results of myopic small-incision lenticule extraction (SMILE). To determine the influence of extreme (flat and steep) corneal keratometry on the safety and efficacy of SMILE, the databases of the Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany, and SMILE Eyes Linz, Austria, were screened for patients with steep and flat keratometry who had undergone SMILE. In this cross-sectional matched comparative cohort study, eyes with markedly flat (< 42.0 diopters; D) or steep (≥ 47.0D) preoperative corneal keratometry were matched to a cohort of eyes with regular keratometry (42.0–46.9D) by preoperative manifest refractive spherical equivalent and cylinder, age, corrected distance visual acuity and surgical SMILE parameters. The standardized graphs and terms for refractive surgery results were applied to compare the three groups. Changes in higher order aberrations (HOAs) were evaluated on Scheimpflug imaging. In total, 63 eyes (21 each) of 54 patients with a mean refractive spherical equivalent of  − 5.21 ± 1.59 D were followed up for a mean of 9.2 ± 6.1 (minimum ≥ 3) months. Mean baseline keratometry was 41.3 ± 0.7D (flat), 45.5 ± 1.0D (regular) and 47.7 ± 0.6D (steep) (p < 0.0001). Compared to the regular group, the flat and the steep cornea group resulted in a non-inferior percentage of eyes within ± 0.50 D of target refraction (p = 0.20), uncorrected distance visual acuity (p = 0.95) and corrected distance visual acuity (p = 0.20). Flat corneas however experienced a stronger induction of spherical aberration (SA) compared to the steep group (p = 0.0005). In conclusion, non-inferior outcomes of SMILE can also be expected in eyes with steep (≥ 47D) or flat (< 42D) preoperative keratometry, while SMILE however induces more SA in eyes with a flat keratometry.
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spelling pubmed-84263922021-09-09 Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE) Luft, Nikolaus Siedlecki, Jakob Reinking, Franziska Mayer, Wolfgang J. Schworm, Benedikt Kassumeh, Stefan Priglinger, Siegfried G. Dirisamer, Martin Sci Rep Article Little is known about the connection between preoperative keratometry and postoperative results of myopic small-incision lenticule extraction (SMILE). To determine the influence of extreme (flat and steep) corneal keratometry on the safety and efficacy of SMILE, the databases of the Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany, and SMILE Eyes Linz, Austria, were screened for patients with steep and flat keratometry who had undergone SMILE. In this cross-sectional matched comparative cohort study, eyes with markedly flat (< 42.0 diopters; D) or steep (≥ 47.0D) preoperative corneal keratometry were matched to a cohort of eyes with regular keratometry (42.0–46.9D) by preoperative manifest refractive spherical equivalent and cylinder, age, corrected distance visual acuity and surgical SMILE parameters. The standardized graphs and terms for refractive surgery results were applied to compare the three groups. Changes in higher order aberrations (HOAs) were evaluated on Scheimpflug imaging. In total, 63 eyes (21 each) of 54 patients with a mean refractive spherical equivalent of  − 5.21 ± 1.59 D were followed up for a mean of 9.2 ± 6.1 (minimum ≥ 3) months. Mean baseline keratometry was 41.3 ± 0.7D (flat), 45.5 ± 1.0D (regular) and 47.7 ± 0.6D (steep) (p < 0.0001). Compared to the regular group, the flat and the steep cornea group resulted in a non-inferior percentage of eyes within ± 0.50 D of target refraction (p = 0.20), uncorrected distance visual acuity (p = 0.95) and corrected distance visual acuity (p = 0.20). Flat corneas however experienced a stronger induction of spherical aberration (SA) compared to the steep group (p = 0.0005). In conclusion, non-inferior outcomes of SMILE can also be expected in eyes with steep (≥ 47D) or flat (< 42D) preoperative keratometry, while SMILE however induces more SA in eyes with a flat keratometry. Nature Publishing Group UK 2021-09-08 /pmc/articles/PMC8426392/ /pubmed/34497302 http://dx.doi.org/10.1038/s41598-021-97375-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Luft, Nikolaus
Siedlecki, Jakob
Reinking, Franziska
Mayer, Wolfgang J.
Schworm, Benedikt
Kassumeh, Stefan
Priglinger, Siegfried G.
Dirisamer, Martin
Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title_full Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title_fullStr Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title_full_unstemmed Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title_short Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)
title_sort impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (smile)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426392/
https://www.ncbi.nlm.nih.gov/pubmed/34497302
http://dx.doi.org/10.1038/s41598-021-97375-4
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