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Small incision lenticule extraction (SMILE): predictors for the outcome of almost 1000 treatments of myopic astigmatism

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Session Details

Session Title: Moderated Poster Session: Refractive

Session Date/Time: Saturday 05/09/2015 | 14:00-15:00

Paper Time: 14:40

Venue: Poster Village: Pod 1

First Author: : R.Hansen DENMARK

Co Author(s): :    N. Lyhne   J. Grauslund   A. Vestergaard        

Abstract Details


To study if the degree of refractive error treated influences the predictability, efficacy, or safety in small-incision lenticule extraction (SMILE) treatments for myopic astigmatism.


Department of Ophthalmology, Odense University Hospital, Odense, Denmark.


Retrospective study of SMILE treatments performed from 2011 to 2014. Inclusion criteria: Corrected distance visual acuity (CDVA) ≤ 0.10 (logMAR) before surgery, and no other ocular conditions than myopia up to -10 D with or without astigmatism of maximum 3 D. Exclusion criteria: Re-treated eyes. All treatments were performed with a VisuMax® femtosecond laser (Carl Zeiss-Meditec, Jena, Germany). Lenticule diameter ranged from 6.00 to 6.60 mm. Maximum attempted spherical correction was -10.00 D. Clinical examinations were performed, and results were analyzed pre-operatively and 3 months post-operatively. Pearson product-moment correlation coefficient (r) was calculated.


Of 1150 treated eyes, 983 were included. Spherical equivalent (SE) refraction averaged -6.77±1.74 D before surgery. At 3 months after surgery, 98% were within ±1.0 D of intended refraction and 13 eyes had lost 2 lines or more of CDVA. Results were analyzed regarding correlations between the degree of refractive error treated and: -refractive predictability (the difference between attempted and achieved spherical equivalent refraction), r = -0.125, p = 0.01. -efficacy (change in CDVA before surgery compared to UDVA after 3 months), r = 0.133, p = 0.03. -safety (CDVA before surgery compared to 3 months after), r = 0.028, p = 0.49.


In SMILE treatments, the predictability and efficacy was correlated with the degree of refractive error treated. Safety was not.

Financial Interest:


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