Objectives:

To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis.

Methods:

In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis.

Results:

At 3-months postoperatively, the residual cylinder was −0.10 ± 0.21 D in the SMILE group and −0.30 ± 0.32 D in the TCL group (p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, −0.19 ± 0.25, −2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, −0.05 ± 0.20, −0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group (p < 0.05).

Conclusion:

Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.

中文翻译：

---

用于散光矫正的小切口微透镜提取和复曲面植入式角膜移植镜片的矢量分析。

目标：

使用矢量分析比较小切口微透镜提取 (SMILE) 和复曲面植入式角膜曲率透镜 (TICL) 植入对近视散光矫正的疗效。

方法：

在这项回顾性研究中，171 例圆柱 1.0 屈光度 (D) 患者的 171 只眼被招募，其中 97 只眼接受了 SMILE，74 只眼接受了 TICL 植入。检查术前和术后 3 个月的视力和屈光结果。使用向量分析比较两组的散光矫正，根据术前圆柱度数进行分级。

结果：

术后 3 个月，SMILE 组残留圆柱为 -0.10 ± 0.21 D，TCL 组为 -0.30 ± 0.32 D（p  < 0.05）。此外，在 SMILE 和 TICL 组中，分别有 98% 和 85% 的眼睛的圆柱度在 ±0.5 D 以内。矢量分析揭示了两组相似的目标诱导散光矢量。然而，TICL 中的差异向量、误差幅度、误差角度和成功指数显着更高（分别为 0.30 ± 0.32 D、-0.19 ± 0.25、-2° ± 4.35° 和 0.16 ± 0.17 D）组比 SMILE 组的值（分别为 0.10 ± 0.21 D、-0.05 ± 0.20、-0.03° ± 2.13° 和 0.05 ± 0.12），无论术前圆柱度如何（所有p < 0.05)。对于术前柱面<2.0 D，SMILE组手术致散光矢量和矫正指数均高于TICL组（p  < 0.05）。

结论：

SMILE和TICL植入都是近视散光矫正的有效技术。然而，使用 SMILE 矫正散光的大小和轴的准确性优于使用 TICL 植入所实现的。