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Determinants of long-term subjective quality of vision after small incision lenticule extraction

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Session Details

Session Title: Small Lenticule Extraction

Session Date/Time: Tuesday 25/09/2018 | 08:00-10:30

Paper Time: 08:45

Venue: Room A3, Podium 3

First Author: : V.Schmelter GERMANY

Co Author(s): :    J. Siedlecki   W. Mayer   T. Kreutzer   S. Priglinger   M. Dirisamer   N. Luft     

Abstract Details


To elucidate the determinants of patient-reported quality of vision after SMILE.


University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany


This prospective cross sectional study included patients that had undergone SMILE for myopia or myopic astigmatism at least 3 months previously. For assessment of visual symptoms, the Quality of Vision (QOV) questionnaire was employed, which constitutes a validated, linear-scaled 30-item instrument providing a QOV score on three scales (symptom frequency, severity and bothersomeness). The respective QOV scores were correlated with a plethora of patients’ baseline characteristics (e.g. age, pachymetry, K-readings), treatment parameters (e.g surgical refractive correction, lenticule/cap thickness) as well as post-operative measurements (e.g. corneal higher-order aberrations, visual acuity, refractive error).


A total of 550 eyes of 275 patients (female to male ratio = 149:126) with a mean follow up of 24 ± 14 months were included. Mean age was 35±9 years and the mean surgically-induced refractive correction amounted to -4.75±1.9 diopters of spherical equivalent. No statistically significant sex-related differences in postoperative QOV were detected. Preliminary analysis showed that the frequency of visual symptoms as assessed with the QOV-instrument was significantly correlated with postoperative uncorrected distance visual acuity (UDVA; p=0.01, r=-0.311) as well as with the postoperative manifest refraction spherical equivalent (MRSE; p=0.001, r=-0.321).


This comprehensive analysis of subjective quality of vision after SMILE adds to our understanding of the complex relationship between objective measurements and subjective patient-reported outcomes of corneal refractive surgery. While we detected no gender-related differences, preliminary data suggests that postoperative MRSE and UDVA are significant determinants of subjective quality of vision after SMILE.

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