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To investigate the relation between induced changes in higher-order aberrations (HOAs) of the cornea and changes in contrast sensitivity (CS) by SMILE, LASIK, and PRK
In 237 eyes of 136 patients having a UCVA of more than 20/25, residual spherical equivalent within ± 1.00 D after SMILE, LASIK, or PRK, HOAs and CS function were investigated before and 6 months after surgery. The amount of myopic correction was 4.87 ± 1.71 D (range, 0.63 - 9.63). Spherical aberration (SA), coma and residual HOAs were measured for a 6-mm pupil using a corneal wavefront analyzer (OPTIKON 2000, Rome, Italy). The cone CS (CCT HD, Konan medical, CA) was used to measure the mean L, M and S-CCT scores as the chromatic contrast, and the area under the log contrast sensitivity function (AULCSF) as the data of the achromatic contrast under the photopic and low mesopic condition.
At 6 months postoperatively, the SMILE and LASIK showed no correlation, but PRK showed a negative correlation between the changes of SA and the changes of chromatic contrast, this can be seen in the following test scores of L, M and S-CCT (r=-0.479, p=0.024, r=-0.515, p=0.014, r=-0.456, p=0.033, respectively). All of the three groups showed no correlation between the changes of SA and the changes of photopic achromatic CS but, SMILE (r=0.227, p=0.035) and PRK (r=-0.512, p=0.015) showed correlation between the changes of SA and the changes of low-mesopic achromatic CS. PRK showed correlation between the changes of residual HOAs and the changes of low-mesopic achromatic CS (r=-0.585, p=0.007).
SMILE results in significantly less induced higher-order aberrations than PRK. In SMILE and LASIK, there was no tendency that the contrast sensitivity was decreased when the higher-order aberrations were increased, but in PRK, chromatic and low-mesopic achromatic contrast tended to be decreased when the higher-order aberrations were increased.