| Purpose: To compare myopic astigmatism correction between Small Incision Lenticule Extraction(SMILE)and Topography-guided femtosecond-assisted laser in situ keratomileusis(FS-LASIK).Methods: A total of 63 patients(126 eyes)were included in this retrospective study.62 eyes were treated with SMILE and 64 eyes were treated with Topography-guided FS-LASIK for myopia with low to moderate(0 to-2.5 D)astigmatism.Uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),corneal curvature,spherical equivalent,residual astigmatism,modulation transfer function(MTF)cutoff frequency and objective scatter index(OSI)were measured preoperatively and at 1 week,1 month and 3 months postoperatively.The effectiveness of myopic astigmatism correction was evaluated using vector analysis.The safety index and efficacy index were used to evaluate the degree of visual recovery.Results: In postoperative 3 month,93.55% in the SMILE group,versus 95.31% in the FS-LASIK group,had 1.0 UDVA,29.03% in the SMILE group,versus 21.88% in the FS-LASIK group,gained 1 line.No difference was found in the safety index and the efficacy index between the SMILE group and the FS-LASIK group in postoperative 3 month(p>0.05).In postoperative 3 month,the spherical equivalent and cylinder refraction in the SMILE group was 0.02±0.43 D,-0.28±0.58 D,respectively,and that of the FS-LASIK group was-0.05±0.46 D,-0.10±0.45 D,respectively.60.00% in the SMILE group,versus 83.33% in the FS-LASIK group,were within ±0.5 D of cylindrical power,significant difference was found in the cylindrical power between the SMILE group and the FS-LASIK group(p<0.05).The changes of spherical equivalent in the SMILE group and the FS-LASIK group from 1 week to 3 months postoperatively were-0.35±0.17 D and-0.46±0.44 D,respectively.The changes of spherical equivalent in the SMILE group were lower than that of the FS-LASIK group(p<0.05).In postoperative 3 months,vector analysis showed the postoperative with-the-rule astigmatism both in the SMILE group and the FS-LASIK group,the correction index(CI)was slightly higher than 1 both in the SMILE group and the FS-LASIK group,the index of success(IOS),the correction index(CI)and the angle of error(AE)in the SMILE group were all higher than that of in the FS-LASIK group,but there no significant statistically difference(p>0.05).In postoperative 3 month,the OSI in the SMILE group and the FS-LASIK group was 0.91±0.58,0.83±0.44,respectively,and the MTF cutoff in the SMILE group and the FS-LASIK group was 37.96±9.46,38.81±9.92,respectively.No difference was found in the OSI and the MTF cutoff between the SMILE group and the FS-LASIK group(p>0.05).Conclusions: 1.Both SMILE and Topography-guided FS-LASIK procedures provide good safety and effectiveness in myopia and myopic astigmatism correction;2.Topography-guided FS-LASIK provides better accuracy than SMILE for the myopic astigmatism correction,but astigmatism after SMILE and Topography-guided FS-LASIK was overcorrected,and the postoperative deviation of astigmatism axis were higher with the SMILE as compared to Topography-guided FS-LASIK;3.The refractive stability in the SMILE group were higher than that of the Topography-guided FS-LASIK group;4.The visual quality in the postoperative early stage were higher with the Topography-guided FS-LASIK as compared to SMILE. |
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