Decentration Of The Corneal Vertex And Lenticule Center In Smartsight Surgery: Its Relationship With Corneal Higher-Order Aberrations
Published 2025 - 43rd Congress of the ESCRS
Reference: FP26.13 | Type: Free paper | DOI: 10.82333/1ahm-2126
Authors: Aki Yoshida* 1 , Ami Igarashi 1 , Toshiki Shimizu 1 , Noriko Inada 2 , Jun Shoji 3 , Satoru Yamagami 1 , Takahiko Hayashi 1
1Ophthalmology,Nihon University,Tokyo,Japan, 2Ophthalmology, Higashimatsuyama Municipal Hospital,Saitama,Japan;Ophthalmology,Nihon University,Tokyo,Japan, 3Ophthalmology,Shoji Eye Clinic,Chiba,Japan;Ophthalmology,Nihon University,Tokyo,Japan
Purpose
This study aimed to analyze the decentration between the corneal vertex, measured using Scheimpflug corneal topography (Sirius, CSO, Italy), and the actual lenticule center during SmartSight surgery. Additionally we evaluated the correlation between the degree of decentration and the postoperative changes in corneal higher-order aberrations (HOAs).
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Setting
First eye clinic in Cheong-ju, Republic of Korea
Methods
In this retrospective study, surgical videos of 310 eyes that underwent SmartSight surgery were analyzed. The decentration between the corneal vertex In preoperative corneal topography and the actual lenticule center was measured. Based on the degree of decentration, the eyes were classified into two groups:
- Group I: Decentration ≤ 0.24 mm
- Group II: Decentration > 0.24 mm
Total HOAs, coma aberration, trefoil aberration, and spherical aberration were compared between groups at preoperative and postoperative one month, three months and six months.
Results
The average decentration from the corneal vertex was 0.18 ± 0.11 mm At postoperative one month, the change in total HOA was 0.05 ± 0.17 in Group I and 0.17 ± 0.23 in Group II. Group I showed smaller change (p <0.05). At 3 and 6 months postoperatively, there were no significant differences between the groups in the changes of total HOAs, trefoil or spherical aberration. However, when compared to preoperative values, the change in coma aberration at 3 months (Group I: 0.09 ± 0.16, Group II: 0.21 ± 0.23) and at 6 months (Group I: 0.12 ± 0.15, Group II: 0.24 ± 0.22) was significantly smaller in Group I (p < 0.05).
Conclusions
A greater decentration between the corneal vertex and the lenticule center is associated with increased induction of corneal HOAs, and it has a sustained impact on coma aberration over time. Achieving optimal centration is essential for obtaining excellent outcomes in SmartSight surgery.