Comparison of outcomes after SMILE using VISUMAX 800 and VISUMAX 500 for correcting myopia and myopic astigmatism: a systematic review and meta-analysis.
- 1Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Beijing University of Chinese Medicine, Beijing, China.
- 2Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, United States.
Abstract
Background
The aim of this study was to compare the outcomes of correcting myopia and myopic astigmatism between small incision lenticule extraction (SMILE) surgery performed using VisuMax 500 (SMILE group) and that using VisuMax 800 (SMILE Pro group).Methods
PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched up to February 2026 to identify relevant studies. The PRISMA guidelines were followed. Primary outcomes were postoperative efficacy, safety, and predictability at the end of follow-up. Secondary outcomes were the postoperative high-order aberrations (HOAs) parameters and the vector analysis parameters.Results
A total of nine studies including 1,692 eyes were involved, with 1,036 eyes undergoing SMILE surgery, 656 eyes undergoing SMILE Pro surgery. All of the 9 selected studies were nonrandomized comparative studies (NRCSs) with the follow-up period ranged from 1 to 6 months. Compared with SMILE, SMILE Pro group had better stability of corrected vision (OR, 0.47; 95% CI, 0.25 to 0.86). As for cylinder and vector analysis, SMILE group showed a marginally greater residual cylinder than the SMILE Pro group ( MD=-0.06 ; 95% CI, - 0.13 to 0.00). There was statistically significant difference in |AE| between the two groups ( MD=4.29 ; 95% CI, 2.34 to 6.24), suggesting that the SMILE group tended toward under-correction, while the SMILE Pro group tended toward over-correction. The post-operative UDVA, spherical equivalent (SE), and higher order aberrations and other vector analysis parameters between the two groups were not statistically significant.Conclusions
Within the limitations of this study, we did not detect evidence of statistical difference between SMILE and SMILE Pro surgical procedures when used for the treatment of myopia and astigmatism. SMILE Pro using VISUMAX 800 provided more accurate refractive cylinder outcomes. Further multicentre studies with larger sample sizes and longer follow-up are warranted to confirm VisuMax 800 system superior practical benefits in surgical workflow, refractive outcomes and patient comfort.
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BibTeX
@article{li2026comparison,
title = {{Comparison of outcomes after SMILE using VISUMAX 800 and VISUMAX 500 for correcting myopia and myopic astigmatism: a systematic review and meta-analysis.}},
author = {Gang Li and Yinganqi Li},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1899883},
url = {https://europepmc.org/article/MED/42909235},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparison of outcomes after SMILE using VISUMAX 800 and VISUMAX 500 for correcting myopia and myopic astigmatism: a systematic review and meta-analysis.
AU - Gang Li
AU - Yinganqi Li
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1899883
UR - https://europepmc.org/article/MED/42909235
AB - Background The aim of this study was to compare the outcomes of correcting myopia and myopic astigmatism between small incision lenticule extraction (SMILE) surgery performed using VisuMax 500 (SMILE group) and that using VisuMax 800 (SMILE Pro group).Methods PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched up to February 2026 to identify relevant studies. The PRISMA guidelines were followed. Primary outcomes were postoperative efficacy, safety, and predictability at the end of follow-up. Secondary outcomes were the postoperative high-order aberrations (HOAs) parameters and the vector analysis parameters.Results A total of nine studies including 1,692 eyes were involved, with 1,036 eyes undergoing SMILE surgery, 656 eyes undergoing SMILE Pro surgery. All of the 9 selected studies were nonrandomized comparative studies (NRCSs) with the follow-up period ranged from 1 to 6 months. Compared with SMILE, SMILE Pro group had better stability of corrected vision (OR, 0.47; 95% CI, 0.25 to 0.86). As for cylinder and vector analysis, SMILE group showed a marginally greater residual cylinder than the SMILE Pro group ( MD=-0.06 ; 95% CI, - 0.13 to 0.00). There was statistically significant difference in |AE| between the two groups ( MD=4.29 ; 95% CI, 2.34 to 6.24), suggesting that the SMILE group tended toward under-correction, while the SMILE Pro group tended toward over-correction. The post-operative UDVA, spherical equivalent (SE), and higher order aberrations and other vector analysis parameters between the two groups were not statistically significant.Conclusions Within the limitations of this study, we did not detect evidence of statistical difference between SMILE and SMILE Pro surgical procedures when used for the treatment of myopia and astigmatism. SMILE Pro using VISUMAX 800 provided more accurate refractive cylinder outcomes. Further multicentre studies with larger sample sizes and longer follow-up are warranted to confirm VisuMax 800 system superior practical benefits in surgical workflow, refractive outcomes and patient comfort.
SN - 2296-858X
ER -