Comparative Analysis Of Outcomes Of Lenticule Extraction Using Smile Pro Under General Anesthesia

To evaluate the feasibility of performing SMILE Pro laser vision correction in patients for whom correction under topical/local anesthesia was not possible; to refine technical approaches for safe and comfortable surgery; to compare refractive outcomes with a control group; and to assess the effect of exclusive surgeon control of positioning throughout the procedure.

Russia, Moscow, Doctor’s Shilova Clinic

Group 1 included 52 eyes after bilateral SMILE Pro under general anesthesia. Surgery with topical anesthesia was impossible. Myopia ranged from −1.00 to −8.5 D, mean astigmatism 1.45 D. Procedures were performed using fractionated administration of propofol 200-400 ml with monitoring of blood pressure,heart rate,oxygen saturation,humidified oxygen delivery (3–4 L/min).
The control Group 2 consisted of 60 eyes was comparable by age and mean ametropia parameters.

During docking, laser stages, and lenticule dissection, proprietary instruments and positioning-control techniques were used. At 1 and 3 months postoperatively, statistical analysis was performed for uncorrected distance visual acuity, manifest refraction, and higher-order aberrations.

Mean visual acuity on postoperative day 1 in Group 1 was 0.95 versus 1.15 in Group 2. Subjectively, patients in Group 1 were satisfied with the result.
At 1 and 3 months, no statistically significant differences were found in outcomes, including the percentage of eyes achieving uncorrected distance visual acuity of 1.0 (20/20) or better and the mean spherical equivalent refraction. Higher-order aberrations, spherical aberration were comparable in both groups.
Comparative assessment of corneal topography after SMILE under general anesthesia versus SMILE under topical/local anesthesia revealed no substantial differences.

SMILE Pro under general anesthesia makes it possible to achieve high refractive outcomes in patients who cannot undergo the procedure under topical/local anesthesia. However, it requires appropriate anesthesia management and a high level of manual surgical skills.