Reduced energy yields better visual outcomes in SMILE procedures

Dramatic change seen in uncorrected visual acuity

Dermot McGrath

Posted: Friday, September 20, 2019

Jillian Chong MD

Reducing the energy laser settings for small-incision lenticule extraction (SMILE®) procedures results in dramatically improved visual acuity outcomes in the immediate postoperative period, according to a study presented at the Free Paper Forum at the 37th ESCRS Congress.

“The possibility to reduce the energy settings on the laser machine with lower energy per spot and wider spot spacing recently became available in the United States. After making the change, we noticed a dramatic improvement in uncorrected visual acuity one day after surgery with patients reliably achieving 20/20 or better,” said Jillian Chong MD.

Dr Chong’s retrospective study included 20 eyes treated for myopic astigmatism using high-energy settings (130nJ to 150nJ, 4.5µm spot spacing) and 20 eyes treated with lower-energy settings (125nJ, 4.5µm spot spacing) at the Santa Monica Eye Medical Group, California, USA.

The difference in uncorrected visual acuity (UCVA) at day one was highly statistically significant in favour of the low-energy group. In addition, 100% of low-energy eyes versus 39% of conventional-energy eyes achieved UCVA of 20/20 or better on the first postoperative day.

“This improvement may render the SMILE procedure more attractive to patients and to refractive surgeons in the United States and increase the adoption rate of this procedure,” said Dr Chong.