Comparison of Postoperative Corneal Higher-Order Aberrations, Asphericity, Densitometry, and Optical Quality Between SMILE Pro and LASIK: A Retrospective Cohort Study

Purpose

To compare postoperative changes in corneal higher-order aberrations (HOAs), densitometry, and optical quality following SMILE Pro and laser in situ keratomileusis (LASIK), and to investigate the relationship between corneal densitometry and postoperative optical quality. Patients and methods: This retrospective matched cohort study included 60 eyes of 30 patients who underwent SMILE Pro and 60 eyes of 30 age-, sex-, and preoperative spherical equivalent-matched patients who underwent LASIK for myopia at Hanamizuki Eye Clinic between July 2025 and March 2026. Anterior, posterior, and real corneal HOAs, spherical aberration (SA), coma, anterior corneal Q value, and central (0-4 mm) corneal densitometry were evaluated using anterior segment optical coherence tomography (CASIA2). Optical quality was assessed using the modulation transfer function (MTF) Area Ratio (Total and HO) obtained with the OPD-Scan III. Longitudinal comparisons were analyzed using linear mixed-effects models, and correlations were evaluated using Spearman's rank correlation coefficient.