Visual And Refractive Outcomes Of Mixed Astigmatism Treated With Small Incision Lenticule Extraction (Smile) – 6 Months Clinical Experience

To report the 6-months visual and refractive outcomes following SMILE for treatment of mixed astigmatism.

Nethradhama Superspeciality Eye Hospital, Bangalore, India

Eleven eyes of 7 patients with mean age 27±4.36 years were included in the series. In 7 eyes, Myopic SMILE license and in 4 eyes, Hyperopic SMILE license (available as part of an open software) was used for the treatment. The mean post-operative follow up was 6- months.

The mean pre-op sphere, cylinder and SE was 1.59±1.38, -3.27±0.97 and -0.05±1.10 D, which changed to -0.02± 0.36, 0.20± 0.48, and -0.13±0.54 D, respectively 6-months post-op. 82% (9/11) eyes were within ±0.50, while 100% eyes were within ±1.50D of SE, and within ±1.00 D of cylinder correction. All eyes had UDVA better than 20/40, with 64% (7/11) eyes having UDVA of 20/20 or better. Safety and Efficacy indices were 1.02 and 0.94. The mean corneal Higher order aberrations (HOA) increased from 0.111±0.048 to 0.209±0.056 microns (p=0.00), while the mean Objective Scatter Index (OSI) did not show a significant change (pre= 0.78±0.77, 6 months= 0.74±0.18, p=0.56). No intra-op complications were noted.

Early experience shows the with SMILE was feasible, safe and effective for management of eyes with mixed astigmatism, without any intra-operative complications, unique to the procedure.