Comparison Of Clinical Outcomes Including Higher Order Aberration Induction For Smile Performed With The Visumax 800 Versus Visumax 500 Femtosecond Laser.

To compare the clinical outcomes of small incision lenticule extraction (SMILE) performed with the Visumax 800 versus Visumax 500 femtosecond laser (Carl Zeiss Meditec AG).

Onnuri Smile Eye Clinic, Seoul, Republic of Korea

One hundred eyes of 50 patients who underwent SMILE with Visumax 800 femtosecond laser (SMILE Pro group) and 100 eyes of 50 patients who underwent SMILE with Visumax 500 femtosecond laser (SMILE group) were retrospectively compared. Patients were followed up for 3 months. Standard outcomes analysis was performed, and the two groups were compared. And optic zone decentration and corneal higher-order aberrations (HOAs) were also compared.

The mean lenticule creation time was 28.27 ± 2.34 seconds in the SMILE group, whereas it was 10.33 ± 0.82 seconds in the SMILE Pro group (P < 0.001). At 3 months postoperatively, there was no significant difference in visual acuity, residual refractive errors, and HOAs between both groups. However, decentration was significantly lower in the SMILE Pro group than in the SMILE group (P < 0.001). Both groups showed significant increases in oblique trefoil, vertical coma, horizontal coma, spherical aberration, and total HOAs after the surgery (P < 0.05). The increase of vertical coma was significantly lower in the SMILE Pro group than in the SMILE group (P = 0.034), whereas there was no significant difference between the two groups in the rest.

Both SMILE procedures performed with Visumax 500 and Visumax 800 are comparable in efficacy, safety, and predictability. However, the lenticule creation time was significantly shorter in Visumax 800 than in Visumax 500, and SMILE with Visumax 800 was superior to SMILE with Visumax 500 in centration and vertical coma induction.