Refractive Coupling Effects in Keratorefractive Lenticule Extraction Procedures: A Machine Learning-Assisted Approach.

To evaluate the impact of refractive couplings in myopia and myopic astigmatism with two different keratorefractive lenticule extraction (KLEx) systems. This was a retrospective evaluation of refractive outcomes with two different lasers studying 2,841 eyes undergoing small incision lenticule extraction (SMILE) (VisuMax 500; Carl Zeiss Meditec) and 2,528 eyes undergoing SmartSight (ATOS; SCHWIND eye-tech-solutions GmbH). Coupling effects (derived from the ratio between partial slopes) were determined for sphere and cylinder and for spherical equivalent, cardinal, and oblique astigmatism separately. Statistically significant coupling effects were observed for both the VisuMax and ATOS systems, as indicated by Despite the