{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:53:02Z","timestamp":1777938782147,"version":"3.51.4"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Roma La Sapienza"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the performance of GPT-5 in refractive surgery planning by comparing its recommendations with expert surgeons and reporting visual outcomes of surgeon-planned Smooth Incision Lenticule Keratomileusis (SILK) procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, observational study included 134 eyes from 67 patients who underwent SILK procedure using the ELITA femtosecond laser platform from January 2024 to September 2025. GPT-5 generated refractive plans based on manifest and cycloplegic refraction, autorefractometry, visual acuity, keratometry, and pachymetry. These were compared with surgeon-derived values using paired t-tests and correlation analysis. Preoperative and postoperative (1- and 3-month) uncorrected and corrected distance visual acuity (UDVA, CDVA), mean keratometry (Km), and thinnest corneal point were analyzed. Axis concordance was quantified as the absolute angular deviation (\u0394 Axis) between AI- and surgeon-planned astigmatism axes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AI-generated spherical corrections were more conservative than surgeons\u2019 (\u2212\u20094.29\u2009\u00b1\u20092.42 D vs.\u2009\u2212\u20094.70\u2009\u00b1\u20091.98 D;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0025), whereas cylindrical power did not differ significantly (p\u2009=\u20090.9241). The mean \u0394 Axis was 61.9\u00b0\u2009\u00b1\u200950.1\u00b0, indicating substantial misalignment. UDVA improved from 0.74\u2009\u00b1\u20090.36 logMAR preoperatively to\u2009\u2212\u20090.06\u2009\u00b1\u20090.07 logMAR at 3\u00a0months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), and postoperative UDVA did not differ significantly from preoperative CDVA, confirming excellent visual recovery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GPT-5 generated refractive plans that were partially consistent with expert surgeon decisions but lacked the clinical precision required for clinical implementation. In contrast, surgeon-planned SILK procedures achieved excellent visual acuity, corneal stability, and refractive predictability, reinforcing the safety and efficacy of Kerato Lenticule Extraction (KLEx) in real-world clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-026-04084-w","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:51:14Z","timestamp":1777697474000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["GPT-5\u2013assisted versus expert surgeon refractive planning in smooth incision lenticule keratomileusis (SILK): comparative analysis and visual outcomes"],"prefix":"10.1007","volume":"46","author":[{"given":"Pier Luigi","family":"Surico","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsung-Hsien","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Hui-Kang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao Kai","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele Gallo","family":"Afflitto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Chin","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Perri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Di Zazzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Lanzetta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Chin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"key":"4084_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04698-z","author":"SA Alowais","year":"2023","unstructured":"Alowais SA, Alghamdi SS, Alsuhebany N et al (2023) Revolutionizing healthcare: the role of artificial intelligence in clinical practice. 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