A Nomogram to Improve the Predictability of High Myopic Astigmatism in Small Incision Lenticule Extraction Surgery.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2025-01-01 DOI:10.3928/1081597X-20241126-01

Na Yu, Xiangtao Hou, Chang Liu, Pei Chen, Yiming Ye, Min Lan, Jing Zhuang, Keming Yu

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引用次数: 0

Abstract

Purpose: To evaluate a new regression-derived nomogram for high myopic astigmatism in small incision lenticule extraction (SMILE) surgery.

Methods: In this prospective study, data from 180 eyes with myopic astigmatism ranging from -2.50 to -4.50 diopters (D) at 3 months after SMILE surgery were analyzed to construct the astigmatic nomogram. Linear regression between target induced astigmatism and flattening effect formula was derived as a nomogram to adjust astigmatic treatment. The nomogram was applied to 112 eyes with astigmatism ranging from -2.75 to -4.50 D. Subsequently, 143 eyes (manifest refraction group) with astigmatism greater than 2.50 D from 180 eyes were compared with 112 eyes (astigmatic nomogram group). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive outcomes at 3 months postoperatively were recorded.

Results: At 3 months after surgery, there was no difference in postoperative degree of astigmatism or UDVA between the two groups. In the astigmatic nomogram group, 109 (97%) of the eyes were within ±0.50 D compared with 127 (89%) in the manifest refraction group (P = .010). Target induced astigmatism and surgically induced astigmatism were strongly correlated in both groups. However, the average undercorrection in the manifest refraction group was 8.4% (R² = 0.67), whereas the astigmatic nomogram group displayed 2.7% overcorrection (R² = 0.86). Moreover, interestingly, all eyes in the astigmatic nomogram group had an angle of error within -5° to 5° compared with 137 (95.8%) of the eyes in the manifest refraction group (P = .028).

Conclusions: The astigmatic nomogram, based on regression between target induced astigmatism and flattening effect, could enhance the accuracy and predictability of high myopic astigmatism correction in SMILE surgery. [J Refract Surg. 2025;41(1):e65-e72.].

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提高小切口晶状体摘除手术高度近视散光可预测性的Nomogram方法。

目的：评价小切口晶状体摘除（SMILE）手术高度近视散光的一种新的回归衍生图。方法：在这项前瞻性研究中，对180只近视散光（-2.50 ~ -4.50 D）患者在SMILE手术后3个月的数据进行分析，构建散光图。导出了靶致散光与压平效应之间的线性回归公式，作为调节散光处理的模态图。将散光在-2.75 ~ -4.50 D之间的112只眼应用衍射图，180只眼中散光大于2.50 D的143只眼（明显屈光组）与散光衍射图组112只眼进行比较。记录术后3个月未矫正距离视力（UDVA）、矫正距离视力（CDVA）和屈光情况。结果：术后3个月，两组患者术后散光度、UDVA无明显差异。与明显屈光组127只眼（89%）相比，散光组109只眼（97%）在±0.50 D以内（P = 0.010）。靶源性散光和手术性散光在两组患者中呈强相关。明显屈光组的平均过校正率为8.4% (R2 = 0.67)，而散光组的平均过校正率为2.7% （R2 = 0.86）。此外，有趣的是，与明显屈光组137只（95.8%）的眼睛相比，散光组所有眼睛的角度误差在-5°至5°之间（P = 0.028）。结论：基于靶致散光与压平效应回归的散光图可提高SMILE手术高度近视散光矫正的准确性和可预测性。[J].中国光学精密工程，2015;41(1):1 - 4。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.