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Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Comparative Validation of a VISULYZE-Based Nomogram for Predicting Visual Outcomes and Higher-Order Aberrations After
Lingling Zhao1, Nannan Gao1, Enze Liu1
1Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu, China, ntu.edu.cn.
Purpose:
To validate a novel VISULYZE-based nomogram for high myopia in small incision lenticule extraction (SMILE) surgery.
Methods:
This prospective, nonrandomized controlled trial included 118 eyes of 71 high-myopia patients treated with SMILE using a VisuMax 500-kHz femtosecond laser. High myopia was defined as a spherical equivalent refraction ≤ -6.00 D. Treated eyes were divided into two groups, according to different nomograms received: the conventional surgeon-adjusted nomogram group (n = 71 eyes) and the VISULYZE-based nomogram group (n = 47 eyes). The VISULYZE nomogram was generated by the data from 108 myopic eyes that underwent SMILE surgery at 3 months. The visual outcomes followed up for 3 months for both groups were compared for efficacy, safety, predictability, stability, and higher-order aberrations (HOAs).
Results:
Preop-SE was -6.58 ± 0.50 D in the conventional group and -6.79 ± 0.61 D in the VISULYZE group. At 3 months postoperatively, the SE in the conventional group and the VISULYZE group was -0.16 ± 0.34 D and 0.05 ± 0.40 D (p < 0.05), respectively. It was found that 72% and 100% had a UDVA of 20/20 in the conventional group and VISULYZE group, respectively, while 89% and 99% had an SE within ±0.5 D and ±1.0 D in the conventional group and 89% and 100% in the VISULYZE group. The efficacy indexes were 0.97 ± 0.07 in the conventional group and 1.02 ± 0.06 in the VISULYZE group (p < 0.05). The safety indexes were 1.15 ± 0.10 in the conventional group and 1.15 ± 0.15 in the VISULYZE group (p > 0.05), respectively. The VISULYZE-based nomogram was associated with lower induction of 3rd-order vertical/horizontal coma, total coma, 4th-order spherical aberration, and root mean square (RMS) HOAs.
Conclusions:
The VISULYZE-based nomogram demonstrated comparable safety to the conventional nomogram while achieving significantly superior efficacy and predictability. Additionally, it provided a supportive condition for reducing RMS HOAs after SMILE compared to the conventional approach. Trial Registration: ClinicalTrials.gov: NCT06982807.
