The impact of femtosecond laser small incision lenticule extraction on accommodative function

This retrospective case study assessed the influence of femtosecond laser small incision lenticule extraction (SMILE) on accommodative function. The study included 42 patients from August 2020 to July 2021 at Suining Central Hospital. They were categorized into near-vision fatigue (20 cases) and asymptomatic groups (22 cases) post-surgery. The near-vision fatigue group received visual training. Comparing pre-surgery, one week, and one month after surgery, accommodative changes were analyzed using variance and t-tests. The near-vision fatigue group had lower preoperative accommodative function (PAPM=0.16, PAF<0.001, PPRA=0.009). One-week post-surgery, they experienced further declines (PAPM=0.021, PAF=0.038, PPRA=0.001), but after one month of training, improvements were evident (PAPM<0.001, PBAF=0.005, PPRA<0.001). The asymptomatic group also had temporary declines one week after surgery, recovering by one month. Negative relative accommodation and accommodative response were minimally affected. SMILE surgery briefly reduced accommodative parameters, predominantly in the near-vision fatigue group. Appropriate training effectively alleviated postoperative near-vision discomfort. In conclusion, SMILE surgery affects accommodative function, leading to temporary declines in specific parameters. Adequate training mitigates these effects, enhancing postoperative comfort.