Small incision lenticule extraction (SMILE) is a refractive intrastromal procedure for myopia and myopic astigmatism correction. Most of the studies evaluating astigmatic correction by SMILE reported astigmatic under-correction, especially in high degrees of astigmatism. This under-correction could be due to: first, the active eye tracker or the iris registration is not yet available to overcome the cyclotorsion that occurred during the treatment with the VisuMax femtosecond laser system (Carl Zeiss Meditec, Jena, Germany) which could be overcome by manual compensation technique, especially in higher degrees of cylinders (\> 1.5 diopters (D)). Second, in patients with small lenticule diameters, the more abrupt change in thickness at the edge of the treated area could induce more stromal and epithelial healing in this area. Thus, the astigmatic correction would be less effective with small than large lenticule diameters for similar high preoperative astigmatism. This study assessed the outcome of using a 0.5 millimeter (mm) larger lenticule diameter in the fellow eyes of myopic astigmatic correction SMILE participants. This assessment included the safety and effectiveness indices, the refractive and visual outcomes, the contrast sensitivity, and some morphological outcomes such as corneal curvature and epithelial and corneal thickness.
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The safety index of using 7 and 6.5 mm lenticule diameters SMILE to treat myopic astigmatism
Timeframe: up to 6 months
The efficacy index of using 7 and 6.5 mm lenticule diameters SMILE to treat myopic astigmatism
Timeframe: up to 6 months