Astigmatism

PurposeTo evaluate the initial visual outcomes of Small Incision Lenticule Extraction (SMILE) Pro® using a 2 MHz femtosecond laser (VisuMax 800, Carl Zeiss Meditec) and to assess the efficacy, safety, predictability, accuracy, and complication rate.MethodsThis retrospective analysis included eyes which underwent the SMILE Pro® procedure using VisuMax 800 femtosecond laser to correct myopia. All surgeries were performed by one surgeon (DB). Follow-up was conducted 3 months postoperatively to evaluate visual outcomes after neuroadaptation, corrected visual acuity (CDVA) and intra- and postoperative complications.ResultsOne hundred and fifty-two eyes of 82 patients (mean age 31 ± 6 years) results at 3 months are presented. The mean spherical equivalent (SE) was - 4.44 ± 1.86 D preoperatively while -0.24 ± 0.32 D postoperatively. 99% of eyes achieved SE within ± 1.0 D of attempted correction and 91% were within ± 0.5 D. Efficacy index was 0.93 while the safety index was 1. No complications occurred intra- or postoperatively. No eyes lost more than 1 line of their preoperative CDVA. All highly myopic eyes (- 6.25 to - 10.00 D; n = 18) achieved 20/20 at 3 months postoperatively and were within 0.5 D from the attempted SE and no eyes lost more than 1 line of CDVA.ConclusionThe SMILE Pro® is a safe, efficient, and predictable procedure for the treatment of myopia and myopic astigmatism, with comparable results of conventional SMILE surgery. High myopic eyes achieve better results than low and moderate myopia. No complications were recorded in our patients.

BackgroundStandardization for reporting medical outcomes enables clinical study comparisons and has a fundamental role in research reproducibility. In this context, we present mEYEstro, a free novel standalone application for automated standardized refractive surgery graphs. mEYEstro can be used for single and multiple group comparisons in corneal and intraocular refractive surgery patients. In less than 30 s and with minimal user manipulation, mEYEstro automatically creates the required journal standard graphs while simultaneously performing valid statistical analyses.ResultsThe software produces the following 11 standard graphs; Efficacy: 1. Cumulative uncorrected (UDVA) and corrected visual acuity (CDVA), 2. Difference between UDVA and CDVA, Safety: 3. Change in line of CDVA, Accuracy: 4. Spherical equivalent (SEQ) to intended target, 5. Attempted vs. achieved SEQ, 6. Defocus equivalent (DEQ) accuracy, 7. Refractive astigmatism accuracy, 8. Target-induced astigmatism vs. Surgically-induced astigmatism, 9. Correction index histogram, 10. Angle of error histogram, Stability: 11. SEQ stability over time. Percent proportions, means, standard deviations, Cohen's d effect sizes, and p-values are calculated and displayed on each graph. All graphs can be easily exported as high-resolution TIFF images for figures to use in scientific manuscripts and presentations.ConclusionsmEYEstro software enables clinicians, surgeons, and researchers, to easily and efficiently analyze refractive surgery outcomes using the standardized methodology required by several peer-reviewed ophthalmology journals.

BackgroundTo investigate and compare the vision-related quality of life (QOL) in different types of refractive error (RE).MethodsThis cross-sectional study was performed on 200 subjects, categorized into four groups of 50 each, consisting of subjects with myopia, hyperopia, astigmatism, and emmetropia, the latter being the control group. The mean age of the participants was 23.88 ± 5.87 (range, 15 to 38: 110 females and 90 males). RE was defined as myopia, spherical equivalent (SE) + 0.25 D, astigmatism, cylinder ResultsCorrected myopia, astigmatism, uncorrected myopia, and hyperopia had a lower vision-related QOL than emmetropes. (P ConclusionIndividuals with refractive errors experience a lower QOL score than those without. Notably, the adverse impact on QOL score is significantly greater in myopic cases, particularly very low myopia, compared to other refractive errors. Therefore, it is strongly recommended not to neglect managing very low myopia since it may improve participants' QOL.

PurposeSmall incision lenticule extraction (SMILE) is a popular flapless refractive procedure for myopia and myopic astigmatism, although postoperative corneal biomechanical changes may affect intraocular pressure measurements and glaucoma assessment. This systematic review and meta-analysis aimed to quantify the postoperative underestimation of IOP and changes in corneal biomechanical parameters following SMILE.Materials and methodsA comprehensive literature search of PubMed, Cochrane Library, ScienceDirect, and Scopus databases was performed up to April 30, 2026, according to PRISMA guidelines. Observational studies reporting preoperative and postoperative IOP measurements after SMILE using Goldmann applanation tonometry (GAT), Ocular Response Analyzer (ORA), or Corvis ST were included. Secondary outcomes included changes in corneal hysteresis (CH) and corneal resistance factor (CRF).ResultsSeventeen studies involving 1177 eyes were analyzed. Postoperative IOP was significantly reduced across all tonometric modalities. The pooled mean reduction was greatest with GAT (MD: 3.47 mmHg; 95% CI 2.85-4.10), followed by ORA (MD: 2.50 mmHg; 95% CI 2.06-2.94) and Corvis ST (MD: 1.52 mmHg; 95% CI 0.62-2.42) (all p ConclusionsSMILE leads to significant underestimation of IOP measurements and measurable biomechanical weakening of the cornea. Clinicians should interpret postoperative IOP values cautiously, even when using biomechanically corrected tonometric devices.