Influence Of Optical Zone On Myopic Correction In Smartsight Treatments Using The Atos Femtosecondlaser: A Short-Term Study With 3 Months Follow-Up

Published 2025 - 43rd Congress of the ESCRS

Reference: PO719 | Type: Free paper | DOI: 10.82333/8afh-6259

Authors: Stylianos Christodoulou ¹ , Dimitris Kola* ¹ , Fedonas Herodotou ² , Aikaterini Athanasiadou ³ , Chara Tzavara ⁴ , Neofytos Michael ¹ , Anastasia Neokleous ¹ , Georgina Hadjilouka ⁵ , Sotiria Palioura ⁶

¹Ophthalmology Clinic, Archbishop Makarios III Hospital, State Health Services Organization,Nicosia,Cyprus, ²Department of Ophthalmology, University of Cyprus Medical School,Nicosia,Cyprus, ³Athens Eye Experts Ophthalmology Practice,Athens,Greece, ⁴Department of Biostatistics, National and Kapodistrian University of Athens Medical School,Athens,Greece, ⁵Ophthalmology Clinic, Archbishop Makarios III Hospital, State Health Services Organization,Nicosia,Cyprus;Department of Ophthalmology, University of Cyprus Medical School,Nicosia,Cyprus, ⁶Ophthalmology Clinic, Archbishop Makarios III Hospital, State Health Services Organization,Nicosia,Cyprus;Department of Ophthalmology, University of Cyprus Medical School,Nicosia,Cyprus;Athens Eye Experts Ophthalmology Practice,Athens,Greece

Purpose

To assess the difference of small vs large optical zones in terms of safety, efficacy, and refractive outcomes of lenticule extraction in myopic patients, both with and without astigmatism, employing a femtosecond laser system equipped with an eye-tracker for precise centration and cyclotorsion compensation.

Setting

Maria-Clara Arbelaez, MD, Muscat, Oman
Juan Arbelaez, MD, Muscat, Oman

Methods

This retrospective, non-randomized cohort study, 142 eyes from 78 patients treated consecutively with SmartSight lenticule extraction were retrospectively analysed in two groups with different optical zone [OZ] size (group A: 7.3 to 8,0 mm; group B: 6.3 to 6.5 mm). Both groups included 71 eyes of 39 patients. both mean age was 27 ± 6 years (range 18–42 years), and the mean preoperative SEQ was in group A -1.13 ± 0.31 D (range -0.63 to -2.13 D) and in group B -5.35 ± 1.05 D (range -3.25 to -8.63 D). At the three-month follow-up, visual acuity, SEQ, cylinder, safety index, and efficacy index were analysed individually

Results

3 m pop, mean SEQ group A was 0.00 ± 0.00 D and group B was 0.00 ± 0.00 D 100% within a SEQ of ± 0.50 D of astigmatism or less, ≤ 0.5 D was achieved in 100% in both groups. The change in Snellen lines (difference between preoperative CDVA and postoperative UDVA) showed a gain of 1 or more lines in 52% in group A and 41% in group B. 58% and 46% achieved the same Snellen line in the wide and small OZ group respectively. There was no loss of one or more lines in the 3-months pop in both groups. Safety index was 1.13 and Efficacy index was 1.12 in group A and, Safety and Efficacy, were 1.10 in group B. Pop UDVA [dec] of group A was 1.12±0.14 [0.80 to 1.25] and in group B 1.00±0.15 [0.80 to 1.25] showing a statistically significant

Conclusions

The data from the 3-month follow-up comparing two different sizes of OZ showed no significant difference in refraction (SEQ or cylinder), however, a statistical difference was noticeable in the visual acuity between both groups. As another contributing factor the pre-operative SEQ has to be mentioned as this largely differed between both groups. The data leave it open whether the difference in the post-operative visual acuity is caused by the different OZ or the different pre-operative refraction. Further investigations are necessary. SmartSight has shown to be an effective and safe procedure for addressing myopia and myopic astigmatism, particularly notable for its efficacy in utilizing large optical zones and small diopter ranges.