Impact Of Small Incision Lenticule Extraction Surgery With Visumax 500 And Visumax 800 Platforms On Patients’ Ocular Comfort And Vision-Related Quality Of Life

Published 2026 - 44th Congress of the ESCRS

Reference: POREF198 | Type: Free paper | DOI: 10.82333/42nr-r169

Authors: Prof. Ecosse Lamoureux ¹ , A/Prof. Eva Fenwick ² , A/Prof. Ryan Man ² , Ms Regina Kay Ting Wong ³ , Prof. Dr Marcus Ang ² , A/Prof. Yu-Chi Liu ² , Prof. Dr Jodhbir Mehta* ²

¹Singapore National Eye Centre,Singapore Eye Research Institute,Singapore,Singapore;Duke-NUS Medical School,Singapore,Singapore;Faculty of Medicine, Dentistry and Health Sciences ,University of Melbourne,Melbourne,Australia, ²Singapore National Eye Centre,Singapore Eye Research Institute,Singapore,Singapore;Duke-NUS Medical School,Singapore,Singapore, ³Singapore National Eye Centre,Singapore Eye Research Institute,Singapore,Singapore

Purpose

VisuMax 800 (VM800) provides a faster treatment protocol than VisuMax 500 (VM500) in patients undergoing SMILE (Small Incision Lenticule Extraction) and has been associated with more consistent visual and patient satisfaction outcomes. However, evidence on the effectiveness of the two treatments on improving quality of life (QoL) is limited. We determined the impact of VM800 and VM500 on ocular comfort (CF), vision-specific functioning (VF) and emotional well-being (EM) captured using a novel computerized adaptive testing (CAT) system in patients undergoing bilateral SMILE surgery.

Setting

Using a pre-post design, 99 patients undergoing bilateral SMILE surgery for myopia correction were recruited from the Laser Vision Centre at the Singapore National Eye Centre. Eligible patients were allocated to receive surgery with the VM500 (N=38; Jan 2023-Mar 2024) or VM800 (N=61; Apr 2024-Mar 2026).

Methods

Patients were interviewer-administered the EM and VF domains of the Impact of Vision Impairment CAT (IVI-CAT); and the CF domain of the Myopia Refractive Intervention CAT (MyoRI-CAT) in-clinic using a web-based application. Higher scores indicated better QoL. Assessments were conducted at baseline (BSL) and 1, 3, 6, and 12-mo post-surgery (FU). Sociodemographic and clinical information were collected via in-house survey. Within- and between-group changes in the three QoL outcomes were assessed using repeated measures ANOVA and mixed models with robust standard errors, respectively.

Results

Of the 99 patients (mean±SD age: 29.3±5.2 yrs; 40% male), 38 (38.4%) and 61 (61.6%) underwent VM500 and VM800, respectively. For VM500, VF and EM scores were higher across all FU time-points compared to BSL (P<0.05). Higher CF scores were observed at 3, 6, and 12-mths FU (all P<0.05). For VM800, similar score trajectories were observed for EM and CF, while no significant changes occurred for VF. Between-group comparison showed lower BSL VF scores for VM500 versus VM800 (P=0.001), leading to greater VF improvements across all FU timepoints only for VM500. There were no between-group differences for BSL EM and CF scores; although VM800 had greater CF score improvements versus VM500, with no significant EM differences.

Conclusions

Both techniques resulted in improved CF and EM scores post-surgery, with sustained long-term gains. While VM800 patients did not report a significant increase in VF post-surgery unlike VM500 participants, this is likely due to the very high BSL VF score observed for this group. Importantly, the VM800 procedure resulted in greater post-operative improvements in CF scores compared to the VM500. Overall, both procedures are highly effective from the patient’s perspective. However, our results suggest that the VM800 potentially offers greater ocular CF than VM500.