A Nomogram to Improve the Predictability of High Myopic Astigmatism in Small Incision Lenticule Extraction Surgery

作者：Na Yu, Xiangtao Hou, Chang Liu, Pei Chen, Yiming Ye, Min Lan, Jing Zhuang, Keming Yu · 发表于：Journal of Refractive Surgery · 年份：2025 · DOI：10.3928/1081597x-20241126-01 · 被引用次数：10 · 研究领域：Corneal surgery and disorders、Breast Implant and Reconstruction、Reconstructive Facial Surgery Techniques

Purpose To evaluate a new regression-derived nomogram for high myopic astigmatism in small incision lenticule extraction (SMILE) surgery. Methods In this prospective study, data from 180 eyes with myopic astigmatism ranging from −2.50 to −4.50 diopters (D) at 3 months after SMILE surgery were analyzed to construct the astigmatic nomogram. Linear regression between target induced astigmatism and flattening effect formula was derived as a nomogram to adjust astigmatic treatment. The nomogram was applied to 112 eyes with astigmatism ranging from −2.75 to −4.50 D. Subsequently, 143 eyes (manifest refraction group) with astigmatism greater than 2.50 D from 180 eyes were compared with 112 eyes (astigmatic nomogram group). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive outcomes at 3 months postoperatively were recorded. Results At 3 months after surgery, there was no difference in postoperative degree of astigmatism or UDVA between the two groups. In the astigmatic nomogram group, 109 (97%) of the eyes were within ±0.50 D compared with 127 (89%) in the manifest refraction group ( P = .010). Target induced astigmatism and surgically induced astigmatism were strongly correlated in both groups. However, the average undercorrection in the manifest refraction group was 8.4% ( R 2 = 0.67), whereas the astigmatic nomogram group displayed 2.7% overcorrection ( R 2 = 0.86). Moreover, interestingly, all eyes in the astigmatic nomogram group ...