Post-operative outcomes of small-incision lenticule extraction in patients with moderate to high astigmatism

Purpose: To evaluate the visual outcomes of patients who underwent small-incision lenticule extraction (SMILE) for the treatment of myopic astigmatism with high cylinders (>2.5 diopters, D). Methods: Forty-two eyes of myopic astigmatism with a spherical error of magnitude between - 0.5 and - 6.0 Ds, cylindrical error of - 2.5 to - 4.5 Dcyl were included in the retrospective study. All patients were tested preoperatively and on days 1, 10, and 30 for uncorrected distance visual acuity, manifest refraction, and corrected distance visual acuity. Additional preoperative assessments were done including measurement of corneal thickness, corneal topography, and examination for ocular surface disease. All procedures were performed by a single experienced surgeon. VisuMax laser system (Carl Zeiss Meditec AG, Jena, Germany) was utilized for all the corrective refractive procedures. Results: Forty-two eyes were included. The logarithm of the minimum angle of resolution Uncorrected distance visual acuity (UDVA) was 1 +/- 0.25 preoperatively and 0.00 +/- 0.00 on postoperative day 30. There was no loss of corrected distance visual acuity (CDVA) lines. Conclusion: SMILE is a successful procedure in the treatment of both myopic spherical and cylindrical refractive errors including high cylindrical errors >-3 to - 4.5 Dcyl.