PurposeWe aimed to present the visual results obtained in 100 small incision lenticule extraction (SMILE) refractive surgeries, demonstrate whether the technique is effective in the treatment of moderate and high myopia, and observe the follow-up of these patients over 24-month period.MethodsOne hundred eyes of 50 consecutive patients were treated with SMILE. The preoperative spherical equivalent refraction was -5.641.23 D. During the postoperative period, patients were examined at 3, 6, 12, and 24months. We analysed the efficacy, safety, predictability, and stability of the technique.ResultsThe Snellen visual acuity of 99% of the patients was 20/20 or better after 24months of follow-up. Two eyes had a loss of two lines of visual acuity; 1% of the patients had a loss of one line of visual acuity. The postoperative spherical refraction was -0.04 +/- 0.35 D (-1.00 to 0.50 D). The postoperative spherical equivalent refraction was -0.19 +/- 0.38 D (-1.25 to 0.50 D). Eighty-three percent of the eyes were within +/- 0.50 D, and 87% obtained a residual astigmatism of 0.50 D or less.Conclusion p id=Par4 The SMILE technique was demonstrated to be an effective, predictable, safe, and stable technique in the treatment of moderate-to-severe myopia during the 24-month follow-up. Long-term follow-up should be undertaken to observe possible refractive regressions.