Large Series 1-Year Outcomes Of Smile Pro For Compound Myopic Astigmatism: Visumax 800 Versus Visumax (500 Khz)
Published 2026 - 44th Congress of the ESCRS
Reference: FP11.06 | Type: Free paper | DOI: 10.82333/12pq-kn08
Authors: Mr Conor Jackson* 1 , Prof. Dan Reinstein 2 , Dr Timothy Archer 1 , Mr Joseph Potter 1 , Ms Ruchi Gupta 1
1London Vision Clinic,London,United Kingdom, 2London Vision Clinic,London,United Kingdom;Columbia University Medical Center,New York,United States;Sorbonne Université,Paris,France;Ulster University,Biomedical Science Research Institute,Coleraine,United Kingdom
Purpose
To compare one-year refractive, visual and safety outcomes of SMILE Pro for compound myopic astigmatism performed with the VISUMAX 800 versus VisuMax (500 kHz) in large single-centre series.
Setting
Private Practice Academic Unit Reinstein Vision, London Vision Clinic, EuroEyes Group, UK
Methods
Retrospective analysis of consecutive eyes treated by one surgeon (DZR). Patients ≤45 years with attempted SEQ to −10.00 D and cylinder to −4.00 D, fully screened including epithelial mapping (MS39 and Insight 100), with preoperative CDVA 20/20 or better. VISUMAX 800 (Sep 2021–Jan 2025) was compared with VisuMax 500 kHz (Aug 2011–Jan 2025) using identical criteria. Standard outcomes and Alpins vector analysis were performed; p values used Welch’s t-test for continuous data and 2×2 chi-square/Fisher exact tests for proportions (counts inferred from rounded percentages).
Results
The VISUMAX 800 cohort comprised 1209 eyes (648 patients) vs the VisuMax (500 kHz) cohort of 3040 eyes (1782 patients). Attempted SEQ −4.52±1.78 D vs −4.52±1.89 D and cylinder −0.82±0.67 D vs −0.81±0.66 D (p≥0.66); mean age 30.7 vs 30.9 years (p=0.43). Pre-op CDVA 20/16 was lower with VISUMAX 800 (73% vs 79%, p=2.7×10−5). Post-op SEQ was similar (−0.11±0.31 D vs −0.12±0.32 D, p=0.35); 90% vs 88% were within ±0.50 D (p=0.065). The cylinder outcomes were also similar (p=0.23). UDVA 20/16 was lower with VISUMAX 800 (48% vs 60%, p=1.23×10−12) while UDVA 20/20 was similar (93% vs 94%, p=0.23). CDVA gain was lower with VISUMAX 800 (17% vs 21%, p=0.0036); line loss rates were similar (p≥0.18).
Conclusions
Both platforms achieved comparable one-year efficacy, safety and predictability for SMILE Pro. Statistically significant differences favoured VisuMax (500 kHz) for achieving 20/16 UDVA and for CDVA line gain, while VISUMAX 800 showed a non-significant trend to slightly higher accuracy within ±0.50 D. No statistical differences were seen between cylinder outcomes, although the VIUMSAX 800 has the advantage of automatic cyclotorsion control.