Comparison of clinical outcomes following small incision lenticule extraction performed with the Visumax 800 versus Visumax 500 femtosecond laser

This study compared clinical outcomes between small incision lenticule extraction (SMILE) procedures performed with the Visumax 800 and Visumax 500 femtosecond lasers. We compared the clinical outcomes of 100 eyes of 50 patients who underwent SMILE using the Visumax 800 (SMILE Pro group) and 100 eyes of 50 patients who underwent SMILE using the Visumax 500 femtosecond laser (SMILE group). Outcomes were assessed at a 3-month follow-up, including standard visual outcomes, optic zone decentration, and corneal higher-order aberrations (HOAs). The mean lenticule creation time was significantly shorter in the SMILE Pro group (10.33 ± 0.82 seconds) than the SMILE group (28.27 ± 2.34 seconds, P  < 0.001). At 3 months postoperatively, the groups had no significant differences in uncorrected or corrected distance visual acuity, residual refractive errors, or corneal HOAs. However, the optic zone decentration was significantly smaller in the SMILE Pro group than in the SMILE group ( P  < 0.001), and the vertical coma induction was significantly lower in the SMILE Pro group compared with the SMILE group ( P  = 0.034), suggesting that the Visumax 800 provides enhanced centration accuracy, reduced vertical coma induction, and faster lenticule creation, demonstrating comparable efficacy, safety, and predictability to the Visumax 500.