The study was done to evaluate the effect of preoperative keratometry on refractive outcomes after small incision lenticule extraction (SMILE) for myopia.

515 consecutive eyes that had SMILE to correct myopia. Pearson correlation and linear regression were used to determine the relationship between residual spherical equivalent and preoperative keratometry. The same analyses were repeated in the quartiles with the lowest and highest preoperative myopia.

Preoperatively, the mean spherical equivalent was −5.67 ± 1.87 diopters (D) (range: −1.63 to −9.75 D) and the mean keratometry was 43.10 ± 1.30 D (range: 38.90 to 47.00 D). Three months postoperatively, the mean spherical equivalent was −0.07 ± 0.18 D. After adjustment for age, sex, and preoperative spherical equivalent, greater postoperative undercorrection occurred in eyes with steeper corneas (P = .001). Each diopter of steeper keratometry resulted in 0.52% (0.03 D) more undercorrection. Correlation between the mean preoperative keratometry and residual spherical equivalent was significant in the lower preoperative myopia group (r = −0.24, P = .006), but not significant in the higher myopia group (r = −0.02, P = .809).

The study concluded that the preoperative keratometry affects refractive outcomes after SMILE. Steeper corneas have greater undercorrection, especially in eyes with low myopia.