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August 03, 2020
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SMILE can provide stable, predictable outcomes for high myopia correction

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More than 90% of eyes that underwent small incision lenticule extraction for high myopia correction experienced unchanged corrected distance visual acuity or gained one or more line at 36 months, according to a study.

“There is no available tool on the market that corrects very high myopia on the corneal level other than the SMILE procedure,” Ahmed Elmassry, MD, PhD, told Healio/OSN.

Infographic detailing percentage of eyes gained visual acuity after three years

Elmassry and colleagues assessed the stability, safety, predictability and efficacy of SMILE in patients with high myopia. The retrospective, noncomparative analysis included 495 eyes of 270 patients treated with the ReLEx SMILE (Carl Zeiss Meditec) technique for a mean spherical myopic error of –12.84 D and a mean astigmatism of –1.17 D. Overall, 225 patients underwent a bilateral SMILE procedure and 45 had a single eye treated.

Four eyes with intraoperative suction loss had their procedures postponed for 1 day. Each eye was treated successfully using the SMILE parameters, and except for these incidents, no intraoperative complications occurred in the study cohort.

The mean refractive error at 1 month postoperative was –0.72 D, and the mean postoperative astigmatism was –0.83 D. The mean logMAR uncorrected distance visual acuity at the final 3-year follow-up was 0.2.

The changes in visual acuity and other parameters were considered to be minimal and nonsignificant at 3 years, but spherical error experienced a significant change from –0.72 D at 1 month to –1.17 D at 3 years. However, this had an insignificant visual impact.

At 3 years, approximately 94% of eyes had unchanged corrected distance visual acuity or gained one or more lines of vision. Approximately 6% lost one line, and 1% lost two lines.