Outcomes Of Small Incision Lenticule Extraction (Smile) In Elderly Patients

To evaluate the outcomes of small incision lenticule extraction (SMILE) for correction of myopia and astigmatism in patients over 55 years of age, since there is no specific data published for this age group until this date.

Department of Ophthalmology, LMU University Hospital, LMU Munich, Germany & SMILE Eyes Clinic, Linz, Austria

This multicentric retrospective study includes more than 150 presbyopic patients older than 55 who underwent SMILE for the correction of myopia or myopic astigmatism. Pre-SMILE manifest refractive spherical equivalent (MRSE), astigmatism, age, and corrected and distance visual acuity (CDVA) were measured and compared to postoperative refractive and functional outcomes. The outcomes in the elderly patient group >55 years will be compared to a control group of patients under 35 years, matched by preoperative MRSE, who also underwent SMILE for the correction of myopia or myopic astigmatism.

This abstract presents the preliminary data of patients >55 years from one center (SMILE Eyes Clinic Linz, Austria): In total, 29 eyes of 17 patients were treated. Mean age was 57.7 ± 3.2 years and female to male ratio was 6:11. After a mean follow-up of 8.4 ± 7.0 months, a spherical equivalent correction of ±0.50 D from target refraction was achieved in 79% of patients and 93% were within ±1.0 D. Residual astigmatism was ±0.50 D in 89% and ±1.00 D in 100% of eyes. The efficacy index was 0.90, the safety index was 1.08. The proportion of patients with a UDVA of 20/20 or better amounted to 82%. One eye lost more than on line of CDVA.

This preliminary data is the first evaluation of SMILE outcomes in patients over 55 years and shows good efficacy, safety and predictability indices for the correction of myopia and astigmatism in this patient group. This endorses the use of SMILE in elderly patients seeking refractive correction. Compared to already published data, our results do not suggest a tendency towards undercorrection of the refractive cylinder in presbyopic patients.

Since this preliminary analysis only comprises a small sample, the results of the pooled data of all participating centers including over 150 patients as well as a comparison with a matched control group under 35 years remain to be evaluated. The complete results will be presented at the conference.