Comparison Of Visual And Refractive Results, Induced Aberrations, And Objective Scatter Index In Eyes With Normal Versus Large Angle Kappa Following Smile Performed With Visumax 800

: To compare the visual and refractive results, induced aberrations, and objective scatter index in normal versus large angle kappa following SMILE performed with VisuMax 800 (SMILE Pro).

Phacorefractive Dept, Nethradhama Hospitals Pvt Ltd

A total of 50 eyes from 50 patients undergoing SMILE Pro with VisuMax 800 were included for correction of myopia and myopic astigmatism. Eyes were divided into normal angle kappa (<0.5 mm), n=25 eyes, and large angle kappa (>0.5 mm), n=25 eyes. Docking and centration were achieved using the CentraLign-assisted centration aid. Intra-operative decentration value (in mm) was noted from the PDF of treatment planning after the surgery. Post-operatively, UDVA, Objective scatter Index (OSI), induced aberrations, and patient satisfaction were evaluated for both groups.

The mean pre-op angle kappa value in the standard group was 0.07± 0.03 mm versus the large angle kappa group (0.52±0.08 mm), p<0.001. At the end of the 3-month follow-up, the number of eyes seeing 20/20 or better was 92% (n=23) and 88% (n=22) in the normal and large angle kappa groups, respectively. No eye in either group had a loss of 2 lines or more. All eyes in the normal and 96 % (n=24) eyes in the large angle kappa group had post-op SE and cylinder predictability between ±0.5 D. Intra-operative treatment decentration was significantly higher in the large angle kappa group (0.18±0.07 mm) versus the normal angle kappa group (0.11±0.08 mm), p=0.01. 

CentraLign assisted centration resulted in favorable eye results with normal and large angle kappa. Irrespective of the pre-operative value of the angle kappa group, mean decentration in both groups was within 0.2 mm, without any differences in clinical outcomes and patient satisfaction.