Effect of incision location on with-the-rule astigmatism correction after SMILE.

PURPOSE: To explore the influence of two different incision positions of small incision lenticule extraction (SMILE) on astigmatism correction. METHODS: A total of 86 eyes of 86 patients who underwent SMILE surgery were included in this retrospective study. The criteria included that the preoperative astigmatism axis to be within 165° to 180° or 5° to 15°. All eyes were divided into two groups according to the incision position. The incisions of 34 eyes were either located on the superior temporal side of the right eye or superior nasal side of the left eye (120° group), and 52 eyes were located on the superior side (90° group). Vector analysis was used to analyze pre- and postoperative 3-month astigmatism, while subgroup analysis was applied according to the preoperative astigmatism. RESULTS: No significant difference of preoperative parameters was found between the two groups (P > 0.05). The efficacy and safety indexes were 1.11 ± 0.16 and 1.15 ± 0.16 in the 120° group, the numbers were 1.15 ± 0.17 and 1.16 ± 0.14 in the 90° group (P = 0.629 and P = 0.871). There was no significant difference in target-induced astigmatism (TIA), TIA axis, surgically induced astigmatism (SIA) magnitude, SIA axis, distance vision (DV) magnitude, DV axis, correction index (CI), angle of error (AofE), |AofE|, magnitude of error (MofE), index of success (IOS), or flattening index (FI) between 120° group and 90° group (P > 0.05). No significant difference was found in the subgroup analysis (P > 0.05). CONCLUSIONS: The incision position has limited astigmatic effect, and the operation-induced astigmatism of SMILE surgery after 3 months was little.