Visual and refractive outcomes of 100 small incision lenticule extractions (SMILE) in moderate and high myopia: a 24-month follow-up study

  • José-María Sánchez-GonzálezEmail author
  • Federico Alonso-Aliste
Refractive Surgery



We aimed to present the visual results obtained in 100 small incision lenticule extraction (SMILE) refractive surgeries, demonstrate whether the technique is effective in the treatment of moderate and high myopia, and observe the follow-up of these patients over 24-month period.


One hundred eyes of 50 consecutive patients were treated with SMILE. The preoperative spherical equivalent refraction was − 5.64 ± 1.23 D. During the postoperative period, patients were examined at 3, 6, 12, and 24 months. We analysed the efficacy, safety, predictability, and stability of the technique.


The Snellen visual acuity of 99% of the patients was 20/20 or better after 24 months of follow-up. Two eyes had a loss of two lines of visual acuity; 1% of the patients had a loss of one line of visual acuity. The postoperative spherical refraction was − 0.04 ± 0.35 D (− 1.00 to 0.50 D). The postoperative spherical equivalent refraction was − 0.19 ± 0.38 D (− 1.25 to 0.50 D). Eighty-three percent of the eyes were within ± 0.50 D, and 87% obtained a residual astigmatism of 0.50 D or less.


The SMILE technique was demonstrated to be an effective, predictable, safe, and stable technique in the treatment of moderate-to-severe myopia during the 24-month follow-up. Long-term follow-up should be undertaken to observe possible refractive regressions.


Small incision lenticule extraction Visual outcomes Femtosecond Refractive surgery 



Data collection and support help: Amián-Cordero, Jonatan; Hernández-Barahona, Mariano; Castellanos-Gómez, Ignacio; Socas-Priego, Luisa and López-Martos, Nino.

Compliance with ethical standards

Conflict of interest

Sánchez-González, José-María declares that he has no conflict of interest. Alonso-Aliste, Federico declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Physics of Condensed Matter, Optics AreaUniversity of SevilleSevilleSpain
  2. 2.Department of OphthalmologyTecnolaser Clinic Vision®SevilleSpain

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