Abstract
To evaluate the association of system-recorded treatment decentration with 3-month visual, refractive, and higher-order aberration (HOA) outcomes after SMILE Pro (VisuMax 800 femtosecond laser). This secondary exploratory analysis of prospectively collected data included 186 eyes of 94 consecutive patients. Treatment decentration-the system-recorded scalar distance between the corneal vertex and the achieved lenticule center-was categorized as 0.26). ΔHOA was greater in the 0.10-0.20 mm group than in the <0.10 mm group (GEE β = +0.048 μm, 95% CI 0.013-0.082, P = 0.007), whereas rank-based tests were marginal (Kruskal-Wallis P = 0.065), the ≥0.20 mm group did not differ, and the continuous Spearman correlation was not significant (ρ = 0.116, P = 0.114). Within the narrow decentration range achieved with CentraLign-guided SMILE Pro, decentration magnitude was not associated with 3-month visual or refractive outcomes. Smaller higher-order aberration induction was associated with decentration below 0.10 mm than with decentration of 0.10 to <0.20 mm; this association was not observed in the ≥0.20 mm stratum.