ArticleBMC ophthalmology2026
Stromal mechanical anisotropy of the SMILE lenticule shows no detectable association with postoperative refractive error.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundSmall-incision lenticule extraction (SMILE) removes an intrastromal lenticule whose stiffness differs between corneal meridians, producing measurable stromal mechanical anisotropy. Whether this meridional anisotropy biases postoperative refractive or astigmatic outcomes-and could therefore guide individualized treatment-remains unestablished. We tested whether lenticule mechanical anisotropy is associated with axis-specific astigmatic error, using an orthogonal negative control to guard against spurious correlation.
methodsIn this prospective consecutive cohort, 282 patients undergoing SMILE for the correction of myopia or myopic astigmatism were enrolled, and 279 right eyes with complete 3-month follow-up were analyzed. Excised lenticules underwent orientation-registered biaxial mechanical testing to derive the meridional anisotropy index A_mech = (E
resultsRefractive outcomes were excellent (spherical-equivalent error + 0.29 ± 0.39 D; 99.3% within ± 1.00 D; attempted-versus-achieved R² = 0.918). The primary association between A_mech and ΔJ
conclusionsAlthough SMILE lenticules exhibit reproducible meridional mechanical anisotropy, this property did not translate into detectable axis-specific or magnitude-related refractive error in this cohort. The concordant null finding in the orthogonal negative control supports the interpretation that no measurable axis-specific signal was present, rather than a meridian-independent analytical artifact. Lenticule-derived biomechanical metrics therefore appear unlikely, by themselves, to meaningfully refine refractive accuracy through individualized treatment planning in this setting. These conclusions are limited to the ex vivo lenticule-derived metrics evaluated here and should not be generalized to all corneal biomechanical measurements or to their established role in ectasia risk assessment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.