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Updated: Mar 6, 2026

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
[Results of residual ametropia correction using CIRCLE technology after femtosecond laser SMILE surgery]
O A Kostin1, S V Rebrikov1, A I Ovchinnikov1
1Ekaterinburg branch of the Academician S.N. Fyodorov IRTC 'Eye Microsurgery', 4A Akademika Bardina, Ekaterinburg, Sverdlovskaya Oblast, 620149.
Aim:
to evaluate functional results of reoperation performed according to the CIRCLE technology and using the VisuMax femtosecond laser and MEL-80 excimer laser in cases of regression of the refractive effect after SMILE surgery.
Material And Methods:
We studied a group of post-SMILE patients. In those, who showed regression of the refractive effect at 1 year, reoperation was performed according to the CIRCLE technology and using the VisuMax femtosecond laser. The corneal flap was separated from the stromal bed and turned aside. Excimer laser ablation of the stromal bed was performed with the MEL 80 machine. The corneal flap was then placed back and rinsed from both sides. Uncorrected (UCVA) and corrected (BCVA) visual acuity as well as spherical equivalent (SE) were estimated before reoperation, on day 1, and at 1 month.
Results:
After reoperation, BCVA and UCVA improved. Patient refraction became close to emmetropia. Specifically, UCVA was 0.23±0.18 at baseline (i.e. 1 year after SMILE) and 0.93±0.11 after the CIRCLE procedure (p<0.05). The absolute value of SE was 1.86±1.15 D and 0±0 D before and after CIRCLE, respectively (p<0.05). BCVA change was not statistically significant - from 0.95±0.1 to 0.93±0.11 (p>0.05).
Conclusion:
Reoperation performed according to the CIRCLE technology and using the VisuMax femtosecond laser and MEL-80 excimer laser provides an increase in visual acuity in case of post-SMILE regression of the refractive effect.

