Changes Of Visual Quality And Dynamic Binocular Vision Function After SMILE

Objective:The purpose of this study was to evaluate whether full femtosecond laser small incision lens extraction(SMILE)reduces early binocular visual quality and visual function in patients with low to moderate myopia and high myopia,and to evaluate it through stereoscopic vision,perceptual eye position(PEP),and fusion function.In addition,this study also added Naked Eye 3D technology for measurement to explore the feasibility of this technology.Methods:(1)110 patients(220 eyes)with myopia who received SMILE laser treatment at the Optics Center of the People’s Hospital of Guangxi Zhuang Autonomous Region from December 2021 to March 2022 were prospectively selected,and the corrected vision before operation was ≥ 1.0.All patients were divided into low and moderate myopia group(-1.0 D<SE<-6.00D)and high myopia group(SE≥-6.00 D)according to preoperative spherical equivalent(SE).The two groups of patients were examined with the optical quality analysis system(OQAS),the brain visual cognitive function system and the naked eye 3D technology before,1 day after,1 week after,1 month after,and 3 months after the operation,respectively,to compare the preoperative and postoperative modulation scatter index OSI and the transfer function cutoff(MTF cut off),Strehl ratio(SR),simulated contrast vision VA100%,VA20%,VA9%,stereoscopic vision,perceptual eye position,fixation stability,simultaneous vision,binocular inhibition and fusion function.Results:(1)Visual quality The MTF cut off value in the low to moderate myopia group was higher than that in the high myopia group at 3 months after surgery(P<0.05);There was no difference in OSI values between the two groups at 3 months after surgery compared to preoperative values(P>0.05).(2)Fixation stability The fixation stability of the patients in both groups was better than that before surgery 3 months after surgery(P<0.01).(3)Binocular inhibition The binocular balance rate in the low to moderate myopia group was higher at 50 pixels in the horizontal grid at 1 month after surgery than before surgery(P<0.05),and there was no difference between the two groups at 3 months after surgery and before surgery.(4)Stereopsis The normal rate of distant stereoscopic vision in the low to moderate myopia group was higher than that in the high myopia group before surgery(P=0.008),and it was higher three months after surgery than before surgery(P<0.05).There was no difference in preoperative bar grid stereopsis and naked eye stereopsis between the two groups(P>0.05).At 3 months after surgery,the bar grid stereopsis in the low to moderate myopia group was better than that in the high myopia group(P<0.05).There was no difference in naked eye stereopsis between the two groups after surgery and before surgery.(5)Fusion function The convergence and fusion function in the low to moderate myopia group was lower at 3 months after surgery than before surgery(P<0.05).(6)Simultaneous vision There was no difference in the preoperative simultaneous visual function between the two groups(P=0.751),and the number of patients with normal simultaneous visual function after surgery was higher than that before surgery(P<0.05).(7)Perceptual eye position The preoperative normal rate of perceived eye position in the low to moderate myopia group was higher than that in the high myopia group(P=0.019),and there was no difference in perceived eye position between the two groups 3 months after surgery.Conclusion:(1)In the early postoperative stage of SMILE,the visual quality of the eyes decreased compared to before surgery,but then showed an upward trend,and basically returned to the preoperative level by 3 months after surgery.(2)SMILE surgery effectively improved gaze stability,long-distance stereoscopic vision,and simultaneous visual function in both groups of patients.(3)The naked eye 3D technology is reliable and convenient for detecting binocular vision function.