title: Accommodative changes after SMILE for moderate to high myopia correction.
abstract: BACKGROUND
  To investigate accommodative response and accommodative lag changes after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction.
  
  
  METHODS
  A total of 32 eyes of 32 patients with no strabismus who underwent SMILE were enrolled in this prospective clinical study. The accommodative response was obtained viewing monocularly with spherical equivalent refractive error corrected, using an open-field autorefractor at different stimulus levels (2.00D, 2.50D, 3.00D, 4.00D and 5.00D) for the right eye before a standard SMILE surgery and at 1-month follow-up after surgery.
  
  
  RESULTS
  The mean age of the patients were 23.34 ± 2.90 years and the mean preoperative manifest refraction spherical equivalent was -5.74 ± 1.98 diopters. Significant differences were detected in both preoperative and postoperative accommodative responses to different stimulus levels (P < 0.001). Multiple linear regression model analysis revealed preoperative manifest refractive spherical equivalent (P = 0.006) and preoperative accommodative lag (P = 0.04) showed a significant impact on postoperative accommodative lag.
  
  
  CONCLUSIONS
  This is the first report of accommodative changes after SMILE. Our preliminary results showed that a decrease in postoperative accommodative lag that might be related to the relief of the visual discomfort symptom.
authors.affiliation: Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Zheng
authors.affiliation: Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Han
authors.affiliation: Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 19 Baoqing Road, Shanghai, 200031, China. doctzhouxingtao@163.com.
authors.forename: Xingtao
authors.identifier: http://orcid.org/0000-0002-3465-1579
authors.initials: X
authors.lastname: Zhou
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D003319:Corneal Stroma / Q000601:surgery; D048988:Corneal Surgery, Laser / Q000379:methods*; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D054140:Refractive Surgical Procedures / Q000379:methods*; D012044:Regression Analysis; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
keywords: Accommodative lag; Accommodative response; Small incision lenticule extraction (SMILE); Visual discomfort symptom