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已发表论文
SMILE 手术术前矫正不足与术后早期视力恢复：完全矫正与欠矫/过矫对结果的影响
Authors Ma L, Huang Y, Nan W, Yan X, Zhu Y, Chen Q, Zhang Y
Received 23 September 2025
Accepted for publication 24 December 2025
Published 31 December 2025 Volume 2025:19 Pages 4989—4998
DOI https://doi.org/10.2147/OPTH.S569562
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Lu Ma, Yingting Huang, Weijin Nan, Xing Yan, Yannuo Zhu, Qian Chen, Yan Zhang
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
Correspondence: Yan Zhang, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao tong University School of Medicine, Shanghai, 200080, People’s Republic of China, Tel +86 13604334101, Email ahzhangyolanda@163.com
Background: Preoperative suboptimal correction (under/over-correction) is prevalent among myopic SMILE candidates. Existing studies lack data on its impact on early visual recovery and binocular function. This study aims to investigate the impact of preoperative suboptimal correction on early visual recovery in myopes undergoing SMILE and to compare these outcomes to normal values.
Methods: Visual results of 148 eyes with preoperative suboptimal correction were compared with 72 full-corrected eyes after SMILE. Assessments included uncorrected distance visual acuity (UDVA), refraction, visual quality parameters (strehl ratio (SR), the modulation transfer function (MTF) curves), and binocular visual function (perceptual eye position, vergence-divergence dynamic and stereovision) at baseline and 1 week, 1 month and 3 months postoperatively.
Results: UDVA improved significantly faster in the full-correction group (1-week follow-up) versus the suboptimal group (1-month follow-up). The full-correction group exhibited superior SR (P = 0.02) and MTF performance at 4-mm pupil (P < 0.05 at 5 and 10 cycles/degree) at 1 month. Horizontal perceptual deviation transiently increased at 1 month but normalized by 3 months in the suboptimal group. Convergence function decreased at 1 month but returned to baseline at 3 months in the suboptimal correction group, while improved at both 1-month and 3-month visits in the full-correction group. Divergence function improved in both groups with no intergroup differences (all P > 0.05).
Conclusion: Myopic subjects with preoperative suboptimal correction exhibit delayed visual recovery (notably UDVA and binocular function) compared to fully corrected peers after SMILE. These findings confirm SMILE’s safety and efficacy even in eyes with suboptimal presenting visual acuity (PVA), while indicating the need for preoperative counseling to align patient expectations and targeted postoperative visual training to accelerate recovery—strategies that may enhance patient satisfaction.
Keywords: myopia, refractive surgery, suboptimal presenting visual acuity, visual quality, visual recovery
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
Correspondence: Yan Zhang, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao tong University School of Medicine, Shanghai, 200080, People’s Republic of China, Tel +86 13604334101, Email ahzhangyolanda@163.com
Background: Preoperative suboptimal correction (under/over-correction) is prevalent among myopic SMILE candidates. Existing studies lack data on its impact on early visual recovery and binocular function. This study aims to investigate the impact of preoperative suboptimal correction on early visual recovery in myopes undergoing SMILE and to compare these outcomes to normal values.
Methods: Visual results of 148 eyes with preoperative suboptimal correction were compared with 72 full-corrected eyes after SMILE. Assessments included uncorrected distance visual acuity (UDVA), refraction, visual quality parameters (strehl ratio (SR), the modulation transfer function (MTF) curves), and binocular visual function (perceptual eye position, vergence-divergence dynamic and stereovision) at baseline and 1 week, 1 month and 3 months postoperatively.
Results: UDVA improved significantly faster in the full-correction group (1-week follow-up) versus the suboptimal group (1-month follow-up). The full-correction group exhibited superior SR (P = 0.02) and MTF performance at 4-mm pupil (P < 0.05 at 5 and 10 cycles/degree) at 1 month. Horizontal perceptual deviation transiently increased at 1 month but normalized by 3 months in the suboptimal group. Convergence function decreased at 1 month but returned to baseline at 3 months in the suboptimal correction group, while improved at both 1-month and 3-month visits in the full-correction group. Divergence function improved in both groups with no intergroup differences (all P > 0.05).
Conclusion: Myopic subjects with preoperative suboptimal correction exhibit delayed visual recovery (notably UDVA and binocular function) compared to fully corrected peers after SMILE. These findings confirm SMILE’s safety and efficacy even in eyes with suboptimal presenting visual acuity (PVA), while indicating the need for preoperative counseling to align patient expectations and targeted postoperative visual training to accelerate recovery—strategies that may enhance patient satisfaction.
Keywords: myopia, refractive surgery, suboptimal presenting visual acuity, visual quality, visual recovery