PURPOSE To characterize patient-reported long-term quality of vision (QoV) after small-incision lenticule extraction (SMILE), and to identify potential clinical parameters that might predispose to experiencing deteriorated visual quality. SETTING University Eye Hospital, Ludwig-Maximilians-University, Munich, Germany. DESIGN Prospective cross-sectional study. METHODS For the assessment and scoring of visual symptoms, the Quality of Vision questionnaire was employed, which constitutes a clinically validated, linear-scaled 30-item instrument providing a QoV score on three scales (symptom frequency, severity, and bothersome). Subgroup analyses were performed for patient subgroups stratified by baseline characteristics (eg, age) and treatment parameters (eg, surgical refractive correction) as well as refractive outcomes (eg, residual refraction) and visual outcomes (eg, uncorrected distance visual acuity [UDVA]). RESULTS The study comprised 394 eyes of 197 patients (117 women [59.4%], 80 men [40.6%]) were included with a mean postoperative follow-up of 24.4 months ± 14.1 (SD). The QoV scores for symptom frequency, severity, and bothersome were 34.63 ± 13.69, 29.60 ± 12.38, and 24.56 ± 16.00, respectively. Patients with a preoperative binocular corrected distance visual acuity (CDVA) of 20/12.5 or better, patients who lost 1 or more lines of UDVA as compared with preoperative CDVA, patients older than the age of 40, and patients with inadvertent anisometropia more than 0.375 diopters reported worse QoV scores. CONCLUSION The relationship between objective clinical parameters and patient-reported subjective QoV after SMILE seems complex. Defined prognostic factors that convey a higher risk for experiencing visual disturbances were identifiable and should be discussed with patients seeking SMILE treatment during preoperative counseling.

中文翻译：

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小切口小孔镜摘除后患者主观报告的视觉质量的决定因素。

目的表征小切口小孔镜摘除术（SMILE）后患者报告的长期视力质量（QoV），并确定可能导致视觉质量下降的潜在临床参数。地点德国慕尼黑路德维希·马克西米利安斯大学大学眼科医院。设计前瞻性横断面研究。方法使用视觉质量问卷对视觉症状进行评估和评分，该问卷构成了临床验证的线性刻度30项器械，可提供QoV评分的三个等级（症状频率，严重程度和烦躁程度）。根据基线特征（例如年龄）和治疗参数（例如手术屈光矫正）以及屈光结果（例如，残余屈光）和视觉结果（例如，未矫正的远视力[UDVA]）。结果该研究包括197例患者的394眼（117例女性[59.4％]，80例男性[40.6％]），平均术后随访时间为24.4个月±14.1（SD）。症状频率，严重程度和烦躁的QoV评分分别为34.63±13.69、29.60±12.38和24.56±16.00。术前双眼矫正远视力（CDVA）为20 / 12.5或更高的患者，与术前CDVA相比丧失UDVA 1行或更多行的患者，40岁以上的患者以及疏忽性屈光参差超过0.375的患者屈光度报告的QoV得分更差。结论SMILE后客观临床参数与患者报告的主观QoV之间的关系似乎很复杂。