Our First Experiences With The Latest Generation Of Femtosecond Lasers, Visumax 800 From Zeiss; Three-Month Refractive Results, High-Order Aberrations, And Complications After Myopic Small Incision Lenticule Extraction (Smile Pro)

To report three-month outcomes  of the Small Incision Lenticule Extraction  (SMILE pro ) for correction of myopia and myopic astigmatism with  the latest generation of ZEISS Femtosecond  Lasers, VISUMAX 800.

North American Lasik and Eye Surgery Center , Dubai , UAE

In this prospective observational study, between June 15 and December 31 2022, 104  eyes of 53 patients with a mean spherical equivalent (SE) of -3,9±2,6 received the SMILE pro procedure using a VISUMAX femtosecond laser system (Carl Zeiss Meditec AG, Germany) with an 800 kHz repetition rate. Patients were followed up at 1 day, 1 week, 1 month and 3 months after surgery. Uncorrected (UDVA) and corrected distance  visual acuity (CDVA), refraction , corneal  high-order aberrations (HOAs) were obtained in each visit. Perioperative complications were also recorded.  

The mean spherical equivalent of refraction was -0,2±0,4 at 1 month and -0,09±0,4 at 3 months. The percentage of UDVA equal or better than 20/20 was 90.4% at 1 month and 97.1% at 3 months. A loss of 1 line of CDVA was observed in 5 eyes (4,8%) and 2 or more lines in 3 eyes (2,9%) at 1 month; however, a loss of 1 line of CDVA was observed in 1 eye (0.96%) at 3 months. No patient lost 2 or more lines of CDVA at 3 months. Four eyes gained 1 line. The mean change in corneal HOAs from baseline was  0.25±0.1 at 1 month and 0.27±0.1 at 3 months. The most frequent complication reported was difficulty in anterior plan lenticule dissection (6.7%), followed by OBL (4.8%) and incisional abrasion (4.8%). Loss of suction was reported in 1 eye (0.96%).

SMILE pro with VISUMAX 800 produced satisfactory refractive outcomes with a mild induction of HAOs. We observed suction loss lower than rates that has been previously reported.