Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism

Abstract

To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany), at the Department of Ophthalmology, Odense University Hospital, Odense, Denmark. Inclusion criteria were corrected distance visual acuity (CDVA) of 20/25 or better before surgery and no ocular conditions other than myopia up to -10.00 diopters (D) with astigmatism up to 3.00 D. Of the 729 treatments, 722 were included. The spherical equivalent (SE) refraction averaged -6.82 ± 1.66 diopters (D) before surgery. After 3months, 88% of eyes were within ±0.50 D of the intended refraction, whilst 98% were within ±1.00 D. The mean difference between attempted and achieved SE refraction at 3months after surgery was -0.06 ± 0.01 D (range: -1.25 to 1.25 D). In eyes with emmetropia as target refraction (n = 362), 63% had uncorrected distance visual acuity (UDVA) of 20/25 or better 1day after surgery, rising to 83% at 3months after surgery. The average gain in CDVA from before surgery to 3months after surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6%) lost 2 or more lines of CDVA from before surgery to 3months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. In the short term, SMILE seemed predictable, efficient, and safe for treatment of myopia and myopic astigmatism.