biostudies-literatureUnknown15(2)Xiong J<h4>Purpose</h4>To develop and validate a machine learning system for the preoperative prediction of small effective optical zone (EOZ; diameter < 5.5 mm) after small incision lenticule extraction (SMILE).<h4>Methods</h4>In this multicenter cohort study, 1030 multimodal combinations of preoperative parameters (PP), anterior corneal curvature maps (AACM), surgery video frames, and three-month postoperative EOZ diameter from 1030 eyes (634 patients) undergoing SMILE were divided: 677 for training, 85 for primary validation, 85 for internal test, and 183 for external test. The AACM-PP-Model integrating AACM and PP was developed and compared against parameter-only or image-only models, with primary performance evaluated by the area under the receiver operating characteristic curve (AUROC) and Translational vision science & technology26https://www.ebi.ac.uk/biostudies/studies/S-EPMC12927424biostudies-literaturePredicting Small Effective Optical Zone After SMILE via Multimodal Machine Learning Integrating Corneal Topography and Clinical Parameters.PMC12927424Li WXiong JHuang FAi CMa LZhang XLing LGao WDai DCen GGui FfalsePredicting Small Effective Optical Zone After SMILE via Multimodal Machine Learning Integrating Corneal Topography and Clinical Parameters.<h4>Purpose</h4>To develop and validate a machine learning system for the preoperative prediction of small effective optical zone (EOZ; diameter < 5.5 mm) after small incision lenticule extraction (SMILE).<h4>Methods</h4>In this multicenter cohort study, 1030 multimodal combinations of preoperative parameters (PP), anterior corneal curvature maps (AACM), surgery video frames, and three-month postoperative EOZ diameter from 1030 eyes (634 patients) undergoing SMILE were divided: 677 for training, 85 for primary validation, 85 for internal test, and 183 for external test. The AACM-PP-Model integrating AACM and PP was developed and compared against parameter-only or image-only models, with primary performance evaluated by the area under the receiver operating characteristic curve (AUROC) and 2026-01-01T00:00:00Z2026 Feb2026-07-16T17:45:16.025Z2026-07-09T11:09:44.542ZS-EPMC129274244171866010.1167/tvst.15.2.26