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Observational Study
. 2025 Jan 29;45(1):50.
doi: 10.1007/s10792-025-03427-3.

SMILE for correction of myopia in patients during the incipient phase of presbyopia

Ruiyu Zhang #  1   2 , Xiaorui Zhao #  1   2 , Yifei Yuan  1   2 , Yu Zhang  1   2 , Yueguo Chen  3   4
Affiliations
Observational Study

SMILE for correction of myopia in patients during the incipient phase of presbyopia

Ruiyu Zhang et al. Int Ophthalmol. .

Abstract

Purpose: To evaluate clinical outcomes and visual quality 12 months after small incision lenticule extraction (SMILE) for correction of myopia with or without astigmatism in patients during the incipient phase of presbyopia.

Setting: Peking University Third Hospital, Beijing, China.

Design: Retrospective observation study.

Methods: Patients who had SMILE for myopia and myopic astigmatism with binocular plano target refraction and aged between 39 and 45 years were included. Subjective refraction; distance, intermediate, and near visual acuities; defocus curve; anterior corneal surface aberrations and the Strehl ratio; accommodation function, and a subjective questionnaire assessing visual quality in real-life situations were evaluated 12 months postoperatively.

Results: Clinical data of 29 cases were analyzed. The average patient age was 40.10 ± 0.94 years. The mean preoperative manifest refraction was - 4.73 ± 1.11 D (range: - 2.13 to - 6.13 D) of spherical equivalent in right eyes. At the 12-month follow-up, binocular uncorrected distance visual acuity and uncorrected intermediate visual acuity ≥ 20/20 were achieved in all patients, and 96.6% (28/29) of patients achieved uncorrected near visual acuity ≥ 20/25. SMILE induced a statistically significant increase in spherical aberration, coma, and total higher-order aberrations (P < 0.001). For accommodative function, only the negative relative accommodation improved significantly after surgery (P < 0.001). The questionnaire demonstrated high patient satisfaction with near vision, and no one reported having severe visual disturbance.

Conclusion: SMILE appeared to be safe and effective in improving distance vision in patients during the incipient phase of presbyopia, and a satisfactory amount of near vision was maintained in this group of subjects.

Keywords: Accommodative function; Corneal higher-order aberrations; Presbyopia; Small incision lenticule extraction (SMILE); Visual quality.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors declare no competing interests. Ethics approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Peking University Third Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent to participate: Informed consent was obtained from all participants included in the study.

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