Visual Outcomes of SmartSight (SCHWIND ATOS) Refractive Surgery in the Correction of Myopia and Myopic Astigmatism: A Systematic Review
In brief
SmartSight laser yields 20/20 vision in up to 98% of treated eyes
A review of six case series (877 eyes) found that after SmartSight refractive surgery, between 59% and 98% of eyes reached uncorrected distance vision of 20/20 or better, and most eyes landed within ±0.50 diopters of the target. Complications were rare and mild, but the data come only from early observational studies, so longer-term, comparative trials are still needed.
- Journal
- Journal of refractive surgery (Thorofare, N.J. : 1995) (Q1)
- Published
- 1 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Nabila Arifaizha, Muhammad Wahyu Kuncoro Adji, Azzahra Virda Rachmani, Sophia Pujiastuti
- PMID
- 42573219
- DOI
- 10.3928/1081597X-20260609-01
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 16 August 2026): 59% to 98% achieved UDVA 20/20 or better
Abstract
PURPOSE: To systematically review visual outcomes, refractive predictability, astigmatic correction, and safety of SmartSight refractive surgery (SCHWIND eye-tech-solutions GmbH) for the correction of myopia and myopic astigmatism. METHODS: A systematic search of six databases was conducted for studies published from 2020 onward. Peer-reviewed clinical studies reporting visual or refractive outcomes following SmartSight refractive surgery using the SCHWIND ATOS platform (SCHWIND eye-tech-solutions GmbH) were included. Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Risk of bias was assessed using the Joanna Briggs Institute checklist for case series. Due to heterogeneity in study design and outcome reporting, a narrative synthesis was performed. RESULTS: Six studies comprising 877 eyes were included, all observational case series. Postoperative uncorrected distance visual acuity (UDVA) outcomes were favorable, with 59% to 98% of eyes achieving UDVA of 20/20 or better than preoperative corrected distance visual acuity. Refractive predictability ranging from 40% (postoperative day 1) to 98% (3 months) of eyes within ±0.50 diopters (D) and 89% to 100% within ±1.00 D of the intended spherical equivalent correction. Astigmatic correction was favorable, with ⩾96% of eyes achieving residual postoperative cylinder ⩽1.00 D from pre-operative mean cylinder ranging from 0.46 to 1.30 D across studies. Loss of two or more lines of corrected distance visual acuity was uncommon, and reported complications were predominantly mild and transient, occurring both intraoperatively (opaque bubble layer, suction loss) and postoperatively (epithelial defects, incision-related issues). CONCLUSIONS: SmartSight refractive surgery demonstrates favorable visual and refractive outcomes with an acceptable safety profile. However, current evidence remains early, derived mainly from case series with limited follow-up, potential conflicts of interest, and no randomized controlled trials. Further prospective and comparative studies are required to confirm long-term outcomes.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.