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Published on: January 14, 2020
Differential accommodative responses to autostereoscopic 3D visual training in patients following SMILE versus ICL
Weijung Ten1, Xiaosong Han2, Yishan Qian2
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, China; Shanghai Bright Baoshi Eye Hospital, Shanghai 201900, China.
Purpose:
To compare the short-term accommodative responses to autostereoscopic 3D visual training between patients who underwent small incision lenticule extraction (SMILE) and implantable Collamer lens (ICL) surgery.
Method:
This prospective study enrolled 28 myopic patients (14 SMILE, 14 ICL; age: 25.11±1.66 years) at one month postoperatively. Participants underwent a 12-minute autostereoscopic 3D training session displaying a dynamic tennis ball trajectory. Accommodative parameters (amplitude, facility, lag and variability) were measured using Grand Seiko WAM-5500 before and after training. Paired t-tests compared within-group changes, and repeated-measures ANOVA was used to test the Group × Time interaction for each accommodative parameter.
Result:
All surgeries were uneventful. Both groups showed significant post-training increases in accommodative amplitude (SMILE: 7.88±3.48 D to 9.58±3.49 D, p = 0.018; ICL: 8.74±1.41 D to 10.61±2.19 D, p = 0.002) and facility (SMILE: 8.00±3.73 to 9.61±3.36 cycles/min, p = 0.004; ICL: 6.61±5.16 to 9.93±5.95 cycles/min, p = 0.001), with no significant Group × Time interaction for either parameter. In contrast, accommodative lag showed a significant Group × Time interaction (p = 0.021), indicating differential responses between the two surgical groups. Consistent with this interaction, accommodative lag decreased significantly only in the ICL group (1.53±0.25 D to 1.40±0.30 D, p = 0.002), resulting in significantly lower post-training accommodative lag than in the SMILE group (p = 0.014).
Conclusion:
Although short-term autostereoscopic 3D training improves accommodative amplitude and facility in both SMILE and ICL patients, accommodative lag demonstrated a significant Group × Time interaction, with a greater reduction observed in the ICL group.
