A Multicenter Study on Early Outcomes of Small-Incision Lenticule Extraction for Myopia

This study was aimed to investigate the early clinical outcomes of small-incision lenticule extraction (SMILE) to correct both myopia and myopic astigmatism at major clinical centers in Japan. This case series consisted of two hundred fifty-two eyes of 130 consecutive patients who underwent SMILE surgery (29.5 +/- 6.3 years, mean age +/- standard deviation), with spherical equivalents of -4.33 +/- 1.61 D. We determined the safety, efficacy, predictability, stability, and adverse events of this procedure. Corrected distance visual acuity significantly improved, from -0.18 +/- 0.04 preoperatively to -0.19 +/- 0.07 logMAR postoperatively (paired t-test, p < 0.001). Uncorrected distance visual acuity also significantly improved, from 1.05 +/- 0.26 preoperatively to -0.15 +/- 0.11 logMAR postoperatively (p < 0.001). 88% and 98% of eyes were within +/- 0.5 and 1.0 D of the targeted correction, respectively. Changes in manifest spherical equivalent from 1 week postoperatively were 0.02 +/- 0.35 D (p = 0.127). No vision-threatening complications were observed in any of the cases. SMILE performed well in the correction of myopic refractive errors, and we experienced no severe complications in this series, indicating its feasibility as a surgical option for the treatment of these eyes.