Short-term outcomes of small-incision lenticule extraction (SMILE) for low, medium, and high myopia



To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique.


Seventy-one subjects with a mean age of 31.86 ± 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from -1.00 D to -3.00 D, medium from -3.25 D to -5.00 D, and high from -5.25 D to -7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment.


In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively.


Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.

Eur J Ophthalmol 2017; 27(2): 153 - 159




Joaquín Fernández, Almudena Valero, Javier Martínez, David P. Piñero, Manuel Rodríguez-Vallejo

Article History


Financial support: Supported by the Sociedad Española de Cirugía Implanto Refractiva (SECOIR) PUBLIbeCA 2014 grant.
Conflict of interest: Dr. Fernández is a consultant for Carl Zeiss Meditec AG (Jena, Germany). The remaining authors have no financial or proprietary interest in the materials presented herein.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.



  •  Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería - Spain
  •  Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante - Spain
  •  Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante - Spain

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.