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Published on: June 27, 2025
Long-term Observation of Decentration in High and Low-to-moderate Myopia Following Small Incision Lenticule
Xiaosong Han1, Tianze Cui1, Fei Xia1
1Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai 200031, China.
Small Incision Lenticule Extraction (SMILE) surgery shows long-term safety and effectiveness. Myopia degree does not impact long-term decentration after SMILE, a key factor in refractive surgery outcomes.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Corneal Surgery
Background:
- Small Incision Lenticule Extraction (SMILE) is a prevalent refractive surgical procedure.
- Understanding long-term outcomes, including optical zone decentration, is crucial for patient satisfaction and visual quality.
- Previous studies have focused on shorter follow-up periods, necessitating long-term data on SMILE's performance.
Purpose of the Study:
- To evaluate long-term changes in optical zone decentration following SMILE surgery.
- To identify factors associated with decentration in patients with high myopia (HM) and low-to-moderate myopia (LMM).
- To assess the long-term safety, efficacy, and predictability of SMILE across different myopia levels.
Main Methods:
- A prospective study included 47 eyes of 30 patients who underwent SMILE surgery.
- Patients were categorized into HM (27 eyes) and LMM (20 eyes) groups based on preoperative refraction.
- Key outcome measures included visual acuity, refraction, intraocular pressure, axial length, optical zone diameter, decentration, and ablation depth, with follow-up up to 13 years.
Main Results:
- SMILE surgery demonstrated high safety and efficacy with no intraoperative complications.
- Long-term decentration was comparable between HM (0.38 ± 0.20 mm) and LMM (0.48 ± 0.19 mm) groups (p=0.130).
- In the LMM group, decentration correlated negatively with spherical refraction and positively with corneal thickness and axial length; no significant correlations were found in the HM group.
Conclusions:
- SMILE surgery offers excellent long-term safety, efficacy, and predictability.
- The degree of myopia does not significantly influence long-term optical zone decentration after SMILE.
- These findings support SMILE as a reliable refractive surgery option for a wide range of myopia severity.
