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Changes of the effective optical zone after small-incision lenticule extraction and a correlation analysis

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Abstract

The objective of the study is to observe the changes in the effective optical zone (EOZ) after small incision lenticule extraction (SMILE) and explore possible correlations with some influencing factors. In total, 133 eyes after SMILE were divided into the mild to moderate myopia group (− 1.75 D to − 5.75 D, 70 eyes) and the high myopia group (− 6.00 D to − 9.50 D, 63 eyes). The postoperative EOZ was calculated by utilizing the corneal tangential curvature map. Changes in EOZ (△-OZ) were monitored and compared between the two groups. Pearson correlation analysis was conducted to determine the correlation between △-OZ and corneal high-order wavefront aberrations. Multicollinearity analysis and ridge regression analysis were performed to assess the correlation between △-OZ and some corneal parameters. After SMILE, the horizontal EOZ (H-EOZ), vertical EOZ (V-EOZ), and average EOZ (A-EOZ) were significantly smaller than the programmed optical zone (POZ) in both groups (p < 0.05). The difference between V-EOZ and POZ (△V-OZ) and the difference between A-EOZ and POZ (△A-OZ) showed more significant changes in the high myopia group than in the mild to moderate myopia group, and △V-OZ was significantly larger than the difference between H-EOZ and POZ (△H-OZ) in the high myopia group. In both groups, the total high-order aberration (T-HOA) and spherical aberration (SA) both increased after SMILE, and they had a similar significant negative correlation with A-EOZ. Moreover, there was a significant negative correlation between △-OZ and Km (X1), Q-value (X2), spherical equivalent (SE, X3), ablating depth (AD, X4) and △e (X6), and a significant positive correlation between △-OZ and △Q (X5). △H-OZ was expressed as Y1, △V-OZ as Y2, and △A-OZ as Y3. The multiple linear regression equations were as follows: Y1 = 3.683 − 0.065X1, Y2 = 1.549 − 0.469X2 − 0.059X3, Y3 = 4.015 − 0.07X1 − 0.03X3, Y1 = 1.337 − 0.005X4 + 0.413X5, Y2 = 1.265 + 0.469X5, and Y3 = 0.852 − 0.002X4 − 0.398X6. The correlation degree with △A-OZ was ranked as Km > △Q > Q-value > AD > e-value > △e > SE > △Km, as represented by the ridge regression analysis. The EOZ was irregularly reduced after SMILE, which should be taken into consideration in the design of POZ, especially for high myopia. Consideration of the refractive diopter and corneal topography is advised for the design of POZ, the latter of which has greater reference significance.

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Funding

This work was supported by the National Natural Science Foundation of China (No. 82000937), the Hunan Provincial Innovation Foundation for Postgraduate (CX20200317), the Education Foundation of Hunan Province (2020JGZDO11), and the Education Foundation of Xiangya Hospital (2020JGA008).

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Authors and Affiliations

  1. Eye Center of Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China

    Yanyan Fu, Yewei Yin, Yang Zhao, Yuanjun Li, Ying Lu, Aiqun Xiang, Qiuman Fu, Tu Hu, Kaixuan Du, Shengfa Hu, Xiaoying Wu & Dan Wen

  2. Hunan Key Laboratory of Ophthalmology, Changsha, 410008, Hunan, China

    Yanyan Fu, Yewei Yin, Yang Zhao, Yuanjun Li, Ying Lu, Aiqun Xiang, Qiuman Fu, Tu Hu, Kaixuan Du, Shengfa Hu, Xiaoying Wu & Dan Wen

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  1. Yanyan Fu
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Contributions

YYF was involved in the analysis and interpretation of data, providing statistical expertise, and drafting the manuscript. YWY was involved in the conception and design of the study, analysis and interpretation of data, and critical revision of the manuscript. YZ was involved in the collection and analysis of data. YJL and YL were involved in funding acquisition. AQX and QMF were involved in the data collection. TH, KXD, and SFH were involved in the instrumentation. XYW was involved in the supervision and conception of the study. DW was involved in the supervision, conception and design of the study, and funding acquisition. All authors read and approved the final manuscript.

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Correspondence to Dan Wen.

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Yewei Yin and Yanyan Fu are co-first authors.

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Fu, Y., Yin, Y., Zhao, Y. et al. Changes of the effective optical zone after small-incision lenticule extraction and a correlation analysis. Lasers Med Sci 38, 14 (2023). https://doi.org/10.1007/s10103-022-03666-1

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