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Effect of laser energy level on visual outcome and higher-order aberrations in SMILE for high myopia

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Session Details

Session Title: Presented Poster Session: Refractive Surgery New Techniques/Instrumentation/Devices I

Venue: Poster Village: Pod 2

First Author: : B.Acar TURKEY

Co Author(s): :    S. Acar                       

Abstract Details


To evaluate the effect of femtosecond laser energy level on the visual outcome and higher-order aberrations (HOAs) in small-incision lenticule extraction (SMILE) for high myopia


Bati Goz Hospital, Istanbul, Turkey


A total of 48 patients who had bilateral SMILE for high myopia were included. Energy level was 120 nJ in 24 patients (group 1) and 160 nJ in 24 patients (group 2). Spot separation was 4.5 µm in all patients. The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up.


Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (-0.10 ± 0.06 versus 0.04 ± 0.08, resp.; p < 0.001) and week 1 (-0.12 ± 0.07 versus -0.04 ± 0.07, resp.; p = 0.001). The visual acuity improved more rapidly in group 1 than in group 2. The UDVA (in logMAR) was 0.05 ± 0.07 and 0.18 ± 0.09 at day 1 (p < 0.001) and -0.08 ± 0.07 and -0.06 ± 0.06 at six months (p = 0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p = 0.002).


In SMILE, lower energy level is associated with better visual outcome and less induction of HOAs than higher energy level in high myopia. Lower energy levels should be considered in SMILE to increase the visual acuity particularly in the early postoperative period.

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