Factors Affecting Visual Outcome after Small Incision Lenticule Extraction (SMILE) Pro.

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Small Incision Lenticule Extraction (SMILE) is a popular refractive surgical procedure.
• The Visumax 800 platform facilitates SMILE Pro, an advanced version of the technique.
• Understanding factors influencing visual outcomes is crucial for patient selection and surgical planning.

Purpose of the Study:

• To identify factors affecting visual outcomes after SMILE Pro using the Visumax 800.
• To evaluate the early postoperative visual results in a cohort of patients undergoing SMILE Pro.

Main Methods:

• Retrospective, cross-sectional study of 258 eyes from 132 patients who underwent SMILE Pro.
• Inclusion criteria: age ≤40 years, corrected distance visual acuity >20/25, spherical equivalent ≤10.0 D, cylinder <5.0 D.
• Visual outcomes assessed at 1 day and 1 month postoperatively.

Main Results:

• 94% of eyes achieved uncorrected distance visual acuity (UDVA) of 20/20 at 1 month.
• High myopia eyes had 81% UDVA of 20/20, compared to 97% (moderate) and 99% (low) myopia.
• Spherical equivalent, optic zone (OZ), cap thickness, and residual stromal thickness (RST) correlated with UDVA.
• Increased risk of suboptimal UDVA (<20/20) associated with high myopia, small OZ, thin cap, and low RST.

Conclusions:

• SMILE Pro yields promising early postoperative visual outcomes.
• Lower visual outcomes are more common in patients with high myopia.
• Small OZ, thin cap thickness, and low RST are risk factors for not achieving optimal visual acuity post-SMILE.
• Further prospective studies with longer follow-up are warranted.