Refractive results with SMILE using lower energy settings in the United States

PLoS One. 2021 Oct 22;16(10):e0258835. doi: 10.1371/journal.pone.0258835. eCollection 2021.

Abstract

Purpose: To report the visual and refractive results of small incision lenticule extraction (SMILE) with low energy settings in the United States (US) and to evaluate outcomes for low astigmatism treatment.

Setting: Private clinical practice.

Design: Retrospective cohort study.

Methods: This study retrospectively reviewed 462 consecutive eyes that underwent SMILE with lower energy settings. Inclusion criteria included all patients between the ages of 19-39 with myopic astigmatism up to -11.25 diopters (D) spherical equivalent (sphere up to -10.00 D, astigmatism up to -3.00 D), and corrected distance visual acuity of at least 20/25. Eyes with low astigmatism (0.25 D-0.50 D) were also included. Outcome analysis was performed according to the Standard Graphs for Reporting Refractive Surgery at postoperative month (POM) 1, and POM 3-6 when data were available.

Results: The mean preoperative spherical equivalent treated was -4.96 ± 2.07; at POM 1, 92% of eyes achieved uncorrected visual acuity (UCVA) of 20/20 or better and maintained visual stability throughout the remainder of the study. At last visit, 431 eyes (93%) achieved UCVA of 20/20 or better, and 461 eyes (99.8%) were 20/25 or better. Ninety-seven (21%) eyes gained at least 1 Snellen line of corrected distance visual acuity and no eyes lost 2 or more lines. Almost all eyes (n = 453, 98%) were within 0.5D of target; 85% of eyes with low astigmatism had ≤0.25 D at last visit compared to 80% of eyes with moderate astigmatism.

Conclusions: SMILE with U.S.-approved low energy settings is safe, predictable, and efficacious and provides patients with a fast visual recovery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Astigmatism / surgery*
  • Corneal Surgery, Laser / methods*
  • Female
  • Humans
  • Male
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome
  • United States
  • Visual Acuity
  • Young Adult

Grants and funding

This study was funded in part by Carl Zeiss Meditec. This study was also supported by IQ Laser Vision. Carl Zeiss Meditec provided funding in the form of an unrestricted research grant to IQ Laser Vision. IQ Laser Vision provided funding in the form of salaries for ETL, KK, and RTL. The specific roles of these authors listed above are articulated in the ‘author contributions’ statements. The funder Carl Zeiss Meditec participated in the review of study design and manuscript, but had no role in data collection and analysis, decision to publish, preparation of the manuscript, or final approval. The funder IQ Laser Vision assisted in data collection.