The aim of this study is to analyze the early clinical efficacy of topography-guided customized ablation treatment (T-CAT) refractive surgery for correcting myopia and astigmatism.

Retrospective analysis of clinical data of 90 cases (154 eyes) with myopia and astigmatism registered at the Ophthalmology Department of Shijiazhuang People′s Hospital from January 2020 to January 2022. Among them, there were 49 males (83 eyes) and 41 females (71 eyes) ranged from 18 to 40 years with an average age of (25.4±2.5) years. According to the random number table method, patients were divided into control group with 45 cases (78 eyes) and testing group with 45 cases (76 eyes). The control group underwent T-CAT contoura vision-laser epithelial keratomileusis (CV-LASEK), while the testing group underwent T-CAT small incision lenticule extraction (SMILE). Naked eye visual acuity, anterior corneal surface aberration, spherical aberration, spherical degree, cylindrical degree, equivalent spherical degree, correction index (CI), index of success (IOS), flattening index (FI), corneal hysteresis (CH), and corneal resistance factor (CRF) according with normal distribution were expressed as ±s, and compared by t test between the two groups, by paired sample t test before and after surgery. The postoperative complications were expressed as eyes number and percentage and compared by χ² test.

After surgery for 7 days, the naked eye visual acuity, coma and spherical aberration, spherical, cylindrical and equivalent spherical degree, CI, IOS, FI, CH and CRF of patients in the testing group were (0.85±0.12) logMAR, (0.30±0.07)μm, (0.45±0.05)μm, (0.19±0.07)D, (-0.39±0.10)D, (-0.39±011)D, (0.95±0.15)D, (0.44±0.17)D, (2.58±0.25)D, (6.06±0.58)mmHg(1 mmHg=0.133 kPa) and (5.22±0.51)mmHg, respectively; those of patients in the control group were (0.72±0.14)logMAR, (0.38±0.09)μm, (0.59±0.06)μm, (0.21±0.09)D, (-0.40±0.12)D, (-0.40±0.10)D, (0.96±0.17)D, (0.42±0.18)D, (2.56±0.24)D, (6.18±0.63)mmHg and (5.36±0.56)mmHg, respectively. There were significantly differences in the naked eye visual acuity, coma and spherical aberration between the two groups (t=6.180, 6.147, 15.709; P<0.05). There were no significant differences in the others (t=1.537, 0.561, 0.591, 0.387, 0.709, 0.507, 1.229, 1.621; P>0.05). The incidence of postoperative complications in the testing group and the control group were 13.16% and 26.92%, respectively. There were significantly difference in them between the two groups (χ²=4.507, P<0.05).

T-CAT SMILE has good early effectiveness and stability in correcting myopia and astigmatism, with fewer postoperative complications and high safety, and is worth promoting.