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. 2025 Feb 7:19:417-425.
doi: 10.2147/OPTH.S502915. eCollection 2025.

Three-Month Outcomes of SMILE Pro with the VISUMAX 800 for Myopic Astigmatism in a Large Population

Hong Son Cung  1   2 , Lan Huong Thi Tran  1   2 , Thanh Ngoc Tran  1   2
Affiliations

Three-Month Outcomes of SMILE Pro with the VISUMAX 800 for Myopic Astigmatism in a Large Population

Hong Son Cung et al. Clin Ophthalmol. .

Abstract

Purpose: To report the visual and refractive outcomes of small-incision lenticule extraction (SMILE) Pro using a 2 MHz femtosecond laser for myopic astigmatism in a large population of Vietnamese patients.

Methods: This was a retrospective clinical study of subjects that underwent keratorefractive lenticule extraction (KLEx) with the VISUMAX 800 at Hong Son Eye Hospital (Ha Noi, Vietnam) between June 2023 and October 2023. Primary outcome measures of monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction, including vector analysis, were evaluated at 3-months postoperatively. Secondary outcome measures of intraoperative and postoperative complications were also recorded.

Results: A total of 765 eyes from 389 patients (60.66% women, mean age of 23.54±5.20 years) were analyzed 3 months after surgery. The mean preoperative spherical equivalent refraction was -5.98±2.26 D. The postoperative spherical equivalent refraction was within ±0.50 D of the intended target in 81% and within ±1.00 D in 97% of eyes. The mean spherical equivalent refraction was -0.11±0.45 D. UDVA was 20/25 or better in 92% and 20/32 or better in 97% of eyes. The mean postoperative UDVA and CDVA values were 0.05±0.09 and 0.00±0.02 logMAR, respectively. There was no change in CDVA in 99% of eyes. Efficacy index was 0.92, and safety index was 1.00. One eye (0.13%) had a suction loss, which resulted in a lenticule remnant. No other complications were reported during surgery or the postoperative follow-up period.

Conclusion: The current study, carried out on a large cohort of Asian patients, showed SMILE Pro with the VISUMAX 800 was safe and effective for treating myopic astigmatism.

Keywords: SMILE; astigmatism; femtosecond laser; myopia.

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Conflict of interest statement

Writing support was funded by Carl Zeiss Meditec, Inc. The concept of the study was created by the principal investigator. The funder was not involved with the design, data collection, analysis, or interpretation, and did not influence the results of the study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Refractive outcomes three months after SMILE Pro using the VISUMAX 800: (A) uncorrected distance visual acuity; (B) uncorrected distance visual acuity versus corrected distance visual acuity; (C) change in corrected distance visual acuity; (D) spherical equivalent refraction attempted versus achieved; (E) spherical equivalent refraction accuracy; (F) spherical equivalent refraction stability; (G) refractive astigmatism; (H) target induced astigmatism versus surgical induced astigmatism; (I) refractive astigmatism angle of error.
Figure 2
Figure 2
Double-angle plot for the cylinder before and three months after SMILE Pro using the VISUMAX 800.
See this image and copyright information in PMC

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