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To evaluate the visual outcomes of patients undergoing small incision lenticule extraction (SMILE) with stratification of results pre- and post-FDA astigmatism approval, after which the laser power settings on the Visumax (Carl Zeiss) femtosecond laser platform were lowered.
A retrospective chart review of 120 consecutive eyes of 60 patients (with an anticipated 336 consecutive eyes of 168 patients in total) who underwent SMILE at two centers from 2017-2019. Visual outcomes were assessed at post-operative day 1, month 1, and month 3, and further compared between pre- and post-astigmatism approval, where laser power settings were decreased. Enhancement rates were also measured.
At post-operative day 1, 49% of patients had uncorrected visual acuity (UCVA) of 20/20 or better following SMILE, 40% of whom were prior to the laser update compared to 72% of whom were after the update. At post-operative month 3, 79% of patients had UCVA 20/20 or better, 73% of whom were prior to the laser update compared to 83% of whom were after the laser update. Enhancement rate measurements are pending.
Following the Visumax laser power setting update in October 2018, more SMILE patients gained 20/20 UCVA at post-operative day 1 and month 3. Surgeon learning curve may also have contributed to these improved visual outcomes.