PURPOSE To investigate the effect of wavefront aberrations on night vision problems and mesopic contrast threshold after small incision lenticule extraction (SMILE). METHODS Forty-two participants (84 eyes) who underwent SMILE were included in this prospective observational study. Visual outcomes including uncorrected distance visual acuity (UDVA), subjective manifest refraction, mesopic contrast threshold (Binoptometer 4P; Oculus Optikgeräte GmbH), and higher order aberrations (HOAs) were analyzed before and 3 months after surgery. The patient's night vision satisfaction was assessed using a questionnaire. RESULTS The mean spherical equivalent was -5.30 ± 1.38 diopters (D) preoperatively and -0.06 ± 0.15 D postoperatively. UDVA was better than 20/20 in 98.81% of the patients and better than 20/25 in all patients. Scores of night vision satisfaction and glare changed significantly in the postoperative period (F = 8.463, P = .001; F = 69.518, P < .001, respectively). Preoperative spherical diopters (lower order aberrations) were positively correlated with night vision satisfaction (r = -0.329, P = .041) and glare score (r =-0.332, P = .039). Age (odds ratio [OR] = 1.272, 95% CI = 1.019 to 1.589) and preoperative spherical diopter (OR = 0.437, 95% CI = 0.199 to 0.975) were correlated with night vision satisfaction scores by analysis of binary regression. The root mean square value of total HOAs increased 3 months after surgery (t = -6.873, P < .001) with an increase in horizontal coma (Z31) and spherical aberration (Z40) (P < .001). No correlation was observed between glare score and HOAs; however, patients with higher preoperative myopia demonstrated continuously decreasing contrast under mesopic conditions and higher postoperative horizontal coma. CONCLUSIONS Myopic patients with higher preoperative spherical errors experienced more glare at night after SMILE surgery. Postoperative horizontal coma was associated with worse mesopic contrast thresholds. [J Refract Surg. 2021;37(7):446-452.].

中文翻译：

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波前像差对 SMILE 后夜视问题和中间对比度阈值的影响。

目的 研究波前像差对小切口微透镜提取 (SMILE) 后夜视问题和中间对比度阈值的影响。方法 42 名接受 SMILE 治疗的参与者（84 只眼）被纳入这项前瞻性观察研究。在手术前和手术后 3 个月分析视觉结果，包括未矫正远视力 (UDVA)、主观明显屈光度、中视对比度阈值 (Binoptometer 4P; Oculus Optikgeräte GmbH) 和高阶像差 (HOA)。使用问卷评估患者的夜视满意度。结果术前平均等效球镜度数 (D) 为 -5.30 ± 1.38 屈光度 (D)，术后为 -0.06 ± 0.15 D。98.81% 的患者 UDVA 优于 20/20，所有患者的 UDVA 均优于 20/25。术后期间夜视满意度和眩光的得分发生显着变化（分别为 F = 8.463，P = .001；F = 69.518，P < .001）。术前球面屈光度（低阶像差）与夜视满意度（r = -0.329，P = .041）和眩光评分（r =-0.332，P = .039）呈正相关。通过二元回归分析，年龄（比值比 [OR] = 1.272，95% CI = 1.019 至 1.589）和术前球面屈光度（OR = 0.437，95% CI = 0.199 至 0.975）与夜视满意度得分相关。术后 3 个月，总 HOA 的均方根值增加 (t = -6.873, P < .001)，水平彗差 (Z31) 和球面像差 (Z40) (P < .001) 增加。在眩光评分和 HOA 之间没有观察到相关性；然而，术前近视度数较高的患者在中视条件下对比度持续降低，术后水平昏迷度较高。结论 术前球面误差较高的近视患者在 SMILE 手术后夜间会出现更多眩光。术后水平昏迷与较差的中间对比度阈值相关。[J 屈光手术。2021;37(7):446-452.]。