Refractive And Visual Outcomes Of Small Incision Lenticule Extraction (Smile) For Compound Myopic Astigmatism With The Visumax 800

To report refractive and visual outcomes of small incision lenticule extraction (SMILE) using the VISUMAX 800 femtosecond laser (Carl Zeiss Meditec, Jena, Germany).

London Vision Clinic, London, UK

This was a retrospective analysis of consecutive eyes treated by SMILE using the VISUMAX 800 femtosecond laser. Inclusion criteria were patients aged under 45 years, a corrected distance visual acuity (CDVA) of 20/20 or better, and 3 month postoperative timepoint data available for analysis. Standard outcomes analysis and vector analysis by the Alpins method were performed. Mean bilateral procedure time for the 20 most recent cases (after the learning curve) was calculated and compared to the mean bilateral procedure time of the 20 most recent SMILE cases by the same surgeon using the VisuMax (500KHz).

During the study period, 128 eyes of 66 consecutive patients were treated. Three month data were available for 118 eyes (92%), and 10 eyes (8%) were lost to follow up. The mean attempted SEQ was -4.65 ± 1.91 D (range: -1.90 to -10.05 D), and mean age was 30 ± 5 years (range: 20 to 43 years). Postoperative SEQ was within ±0.50 D in 86% and ±1.00 D in 100% of eyes. Uncorrected distance visual acuity was 20/20 or better in 91% of eyes. One line of CDVA was lost in 8% of eyes, and no eyes lost two or more lines. There was a small but statistically significant increase in contrast sensitivity at 3, 6, 12, and 18 cpd. Mean bilateral procedure time for the final 10 cases was 07:57, relative to 08:29 with the VisuMax (500KHz).

Early outcomes data for SMILE with the second generation VISUMAX 800 femtosecond laser demonstrated an effective and safe option equivalent to published first generation VisuMax outcomes for the treatment myopia and astigmatism, but with faster workflow.