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An Analysis of Postoperative Spherical Equivalent Deviation after Small Incision Lenticule Extraction |
Jiabao Chen1 , Chunxia Jiang1, 2, Qinying Huang1, 2, Xiaoxuan Lin1, 2, Jinying Li1 |
1 Department of Ophthalmology, Peking University Shenzhen Hospital, Beijing 518036, China 2 Shantou University Medical College, Shantou 515063, China |
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Guide |
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Abstract Objective: To observe refractive status after femtosecond laser small incision lenticule extraction (SMILE); to explore the causes of postoperative spherical equivalent deviation. Methods: Retrospective case series study. A total of 200 patients (400 eyes) who had undergone SMILE surgery in Peking University Shenzhen Hospital from January 2019 to April 2020 were observed at the 3-month follow-up. Parameters like age, preoperative spherical equivalent (SE), preoperative mean keratometry (Km) and postoperative SE at 1 week, 1 month, 3 months were collected. Patients were divided into 3 groups according to preoperative SE: Low myopia group (≥-3.00 D), moderate myopia group (>-6.00-<-3.00 D), high myopia group (≤-6.00 D), and divided into three groups according to preoperative Km: Low curvature group (≤42 D), moderate curvature group (>42-<45 D), high curvature group (≥45 D). At 1 week, 1 month, and 3 months postoperatively, a Kruskal Wallis test or ANOVA was used to compare the postoperative SE in each group. A Wilcoxon test or paired-samples t test was used to compare the postoperative SE among the two groups divided according to the dominant eye and right/left eyes. The parameters from dominant eyes were analyzed by Spearman correlation coefficient and multiple linear regression. Results: The postoperative SE was negatively correlated with Km, nomogram values and preoperative SE at 1 week postoperatively (r=-0.155, P=0.029; r=-0.174, P=0.014; r=-0.170, P=0.016), and negatively correlated with nomogram values, age and preoperative SE at 1 month postoperatively (r=-0.225, P=0.002; r=-0.148, P=0.046; r=-0.203, P=0.006). The nomogram value (r=-0.338, P=0.002) and preoperative SE (r=-0.336, P=0.002) were negatively correlated with SE 3 months postoperatively. Regression analysis showed that Km (B=-0.033, P=0.047) and preoperative SE (B=-0.037, P=0.017) are the influence factors of postoperative SE at 1 week. Age (B=-0.013, P=0.022) and nomogram value (B=-0.564, P=0.001) are the influence factors of postoperative SE at 1 month. Preoperative SE is the influence factor of postoperative SE at 3 months (B=-0.070, P=0.001). Comparison of the SE between the low, moderate and high myopia groups 1 week (H=6.007, P=0.05), 1 month (H=6.236, P=0.044) and 3 months (H=6.051, P=0.004) postoperatively showed statistically significant differences. The difference in postoperative SE between the right and left eyes was statistically significant at 1 week (Z=-3.327, P=0.001) and 1 month (Z=-3.130, P=0.002) postoperatively but not statistically significant at 3 months. Conclusions: The older and high myopia patients' postoperative refractive status tends to be myopic, meaning undercorrection. The younger and low myopia patients' postoperative refractive status tends to be hyperopic, meaning overcorrection. Postoperative refractive status is influenced by age and preoperative SE. Nomogram is characteristically set according to the influence factors to achieve the maximum surgical effect.
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Received: 11 November 2020
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Fund: Science, Technology and Innovation Commission of Shenzhen Municipality (JCYJ20190809100405621) |
Corresponding Authors:
Jinying Li, Peking University Shenzhen Hospital, Beijing 518036, China (Email: ljyszbdyy@126.com)
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