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Updated: Feb 19, 2026
Ye's Swing Technique for Small-incision Lenticule Extraction Surgery
Published on: June 27, 2025
Early clinical outcomes after small incision lenticule extraction surgery (SMILE)
Alberto Recchioni1, Andreas Hartwig2, Jay Dermott3
1Aston University, Aston Express Way, Birmingham B4 7ET, UK; Optegra Eye Sciences, One Didsbury Point, 2 The Ave, Manchester M20 2EY, UK; University of Valencia, c/Dr. Moliner n° 50; 46100 Burjassot, Valencia, Spain.
Purpose:
Dry eye is known to impact on clinical outcomes after laser vision correction and the use of a newer 'all femtosecond laser' surgical approach may be associated with less impact on the ocular surface post-operatively. The purpose of this study was to evaluate the early clinical outcomes and tear instability after the first small incision lenticule extraction (SMILE) cases undertaken by three surgeons at a single site in the UK.
Methods:
Retrospective audit. Seventy-one eyes of 37 patients underwent SMILE surgery using the Zeiss VisuMax laser system (Carl Zeiss Meditec, Germany). Uncorrected and corrected distance visual acuity, spherical equivalent refraction, fluorescein enhanced tear break up time, simulated keratometry and complications were evaluated pre- and post-operatively where applicable.
Results:
The study population consisted of 21 males and 16 females. The mean±standard deviation age was 33±8years. The results showed that 100% of eyes achieved 20/40 or better and 88% achieved 20/20 or better uncorrected distance visual acuity. The spherical equivalent refraction after surgery was within ±0.50D in 82% of eyes at three months. There was no significant difference in tear break up time from pre-operative levels at three months. Complications were infrequent.
Conclusions:
This early data from surgeons' first SMILE procedures suggest SMILE provides good outcomes in terms of refractive predictability and visual acuity with minimal impact on the tear film. Longitudinal research will further improve our understanding of the longer-term impact of SMILE on clinical outcomes, ocular surface metrics and patient reported outcomes.
