Quality of Vision and Ocular Higher Order Aberrations after SMILE for Myopia and Myopic Astigmatism

Background Previous studies have shown considerable amounts of higher order aberrations following SMILE. In our study we aim at accurately quantifying the higher order aberrations following SMILE in myopia and myopic astigmatism. Objective To detect the effect of SMILE on quality of vision and the incidence of higher order aberrations following SMILE. Patients and Methods This is a prospective study that included 30 eyes of 18 patients presented in the outpatient clinic seeking advice for myopic refractive surgical correction. The study was conducted in accordance with the ethical standards stated by the ethical committee of Ain shams university hospitals with informed consents obtained from all participants. Results On studying the post-operative corneal third order aberrations we detected increase in post-operative vertical and horizontal coma, and spherical aberrations with non-significant change in vertical and horizontal trefoil. According to our study results, SMILE is an effective refractive surgery that improves visual acuity. That causes decrease in quality of vision through modulation transfer ratio and increase in ocular higher order aberrations. Conclusion SMILE (small incision lenticule extraction) is an efficient modality for refractive surgical correction of myopia and myopic astigmatism, with significant post-operative improvement in unaided visual acuity detected post-operative increase in the ocular HOAs. Total coma, trefoil and sphere increase significantly in mesopic more than photopic pupil. The degree of myopia didn’t affect the ocular higher order aberrations except for modulation transfer ratio.