ESCRS - PP03.17 - Refractive Coupling Effects In Lenticule Extraction Procedures: A Machine Learning-Assisted Approach

Refractive Coupling Effects In Lenticule Extraction Procedures: A Machine Learning-Assisted Approach

Published 2024 - 42nd Congress of the ESCRS

Reference: PP03.17 | Type: Free paper | DOI: 10.82333/c3sw-2424

Authors: Kishore Raj Pradhan* 1 , Samuel Arba Mosquera 2

1refractive surgery,Matrika Eye Center,kathmandu,Nepal, 2refractive surgery,Schwind,Frankfurt,Germany

Purpose

To evaluate the impact of refractive couplings in myopia and myopic-astigmatism with two different Lenticule Extraction (LE) systems. 

Setting

Private Practice

Methods

Retrospective evaluation of refractive outcomes studying 1264 eyes undergoing SmartSight (ATOS, SCHWIND eye-tech-solutions GmbH, Germany). Coupling effects (derived from the ratio between partial slopes) were determined for sphere and cylinder, and for spherical equivalent, cardinal, and oblique astigmatism separately. 

Results

For ATOS, no coupling effect of cylinder into sphere was found. The coupling effect of sphere into cylinder was 1%. A 0.1% coupling effect of defocus into oblique astigmatism was found. In cases with no astigmatism plan, sphere had a 0.6% effect on induced astigmatism. In high astigmatism plans additionally, the effect of defocus on oblique astigmatism was 0.8%.

Conclusions

Although statistically significant, coupling effects were consistently low, with magnitudes well below 5%, even for astigmatism exceeding 2.50 D. Coupling values for LE were markedly lower than those reported for non-aspheric excimer laser ablations. Our results suggests that surgical results may be refined further by optimizing nomograms to mitigate coupling effects.