Comparative Validation of a VISULYZE-Based Nomogram for Predicting Visual Outcomes and Higher-Order Aberrations After...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Biomedical Engineering

Background:

• High myopia presents significant challenges in refractive surgery.
• Small Incision Lenticule Extraction (SMILE) is a popular refractive surgery procedure.
• Accurate nomograms are crucial for optimizing SMILE outcomes.

Purpose of the Study:

• To validate a novel VISULYZE-based nomogram for high myopia correction using SMILE.
• To compare the efficacy, safety, predictability, and higher-order aberrations (HOAs) of the VISULYZE nomogram against a conventional surgeon-adjusted nomogram.

Main Methods:

• A prospective, nonrandomized controlled trial involving 118 eyes of 71 high-myopia patients undergoing SMILE.
• Patients were divided into two groups: conventional nomogram (n=71) and VISULYZE nomogram (n=47).
• Visual outcomes, refractive error, and HOAs were assessed at 3 months post-surgery.

Main Results:

• The VISULYZE group achieved significantly better postoperative spherical equivalent (SE) (-0.16±0.34 D vs. 0.05±0.40 D) and higher efficacy (0.97±0.07 vs. 1.02±0.06).
• 100% of the VISULYZE group achieved 20/20 Uncorrected Distance Visual Acuity (UDVA), compared to 72% in the conventional group.
• The VISULYZE nomogram was associated with reduced induction of coma and spherical aberrations, leading to lower RMS HOAs.

Conclusions:

• The VISULYZE-based nomogram offers superior efficacy and predictability in SMILE for high myopia compared to conventional methods.
• It demonstrates comparable safety and a beneficial effect in reducing HOAs post-SMILE.
• This novel nomogram represents a significant advancement in optimizing SMILE outcomes for high myopia patients.