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Updated: Oct 5, 2025
Ye's Swing Technique for Small-incision Lenticule Extraction Surgery
Published on: June 27, 2025
Comparison of astigmatic correction with and without limbal marking during small-incision lenticule extraction
Boyuan Wang1, Yan Wang, Jiamei Zhang
1From the Department of Ophthalmology, The second Hospital of Tianjin Medical University, Tianjin Medical University, Tianjin, China (B. Wang); Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Clinical College of Ophthalmology, Tianjin Medical University, Nankai University, Tianjin, China (Y. Wang, Zhang).
Purpose:
To compare clinical outcomes after correction of moderate to high astigmatism through small-incision lenticule extraction (SMILE) with and without limbal marking.
Setting:
Tianjin Eye Hospital, Tianjin, China.
Design:
Prospective randomized comparative case series.
Methods:
This prospective randomized control study included 240 unilateral eyes of 240 patients who underwent SMILE with astigmatism of more than 0.75 diopters (D). The eyes were randomly assigned to a marked group (120 eyes) or an unmarked control group (120 eyes). Manifest refraction was observed at the 3-month follow-up timepoint and evaluated using a vector analysis.
Results:
Postoperative astigmatism differed statistically significantly in the marked group (-0.08 ± 0.15 D) and the control group (-0.16 ± 0.24 D) at 3 months ( P = .001), and correction index, index of success, angle of error (absolute value), and magnitude of error were also significantly better in the marked group ( P < .05). There was a significant positive correlation between index of success and angle of error (absolute value) ( P < .001).
Conclusions:
Limbal marking-based manual compensation prior to SMILE was associated with a statistically significant reduction in undercorrection and error of axis in cases of moderate to high astigmatism, although the magnitude of the difference was small.
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