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Correction of astigmatism with SMILE

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Session Details

Session Title: Small Lenticule Extraction

Session Date/Time: Sunday 08/10/2017 | 11:00-12:30

Paper Time: 12:03

Venue: Room 3.6

First Author: : S.Taneri GERMANY

Co Author(s): :    S. Kiessler   A. Rost   T. Schultz   M. Elling   H. Dick        

Abstract Details


Eyes with myopic astigmatism may be eligible for full correction with Small Incision Lenticule Extraction (SMILE). However, SMILE is currently only FDA-approved for the correction of astigmatism up to 1 diopter (D). We report refractive outcomes of SMILE in myopic eyes with astigmatism of 1 D or higher.


Center for Refractive Surgery, Eye Department at St. Francis Hospital, Muenster, Germany


Observational case series of consecutive SMILE surgeries in myopic eyes with astigmatism from 1 D to 5 D. Same surgeon performed SMILE in 111 eyes with the VISUMAX 500 Hz femtosecond laser platform (Zeiss, Oberkochen, Germany). Inclusion criteria: Myopia more than -0.5 D, astigmatism 1.0 D or more, and corrected distance visual acuity (CDVA) of 1.0 (decimal scale) or better. Outcome analysis at 3 months: uncorrected distance visual acuity (UDVA, decimal scale), CDVA (decimal scale), subjective refraction, and objective refraction according to the Standard Graphs for Reporting Refractive Surgery, and also including efficacy index.


Preoperatively, mean spherical equivalent refraction was -5.43 ± 2.4D (range: -1.38 to -10.25D) and mean cylinder was -1.76 ± 0.85 D (range: -1.00 to -4.75D). Postoperatively, mean spherical equivalent refraction was -0.04 ± 0.43D (range: -1.50 to +0.75D) and mean cylinder was -0.40D ± 0.85D (range: 0.0 to -2.25D). Mean UDVA was 1.05. Mean efficacy index was 0.85. UDVA same or better than CDVA: 48%. Angle of Error was ± 5 degrees in 66% and ± 15 degrees in 96%. Astigmatism was ≤ 0.5 D in 81% and ≤ 1D in 97%.


SMILE for the correction of myopic astigmatism was found to be safe and effective with outcomes similar to those previously reported for LASIK. Results may be improved in the future with compensation of cyclotorsional eye-movements.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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