Abstract
PURPOSE: To evaluate the effects of patient age and sex on the early visual outcomes of small-incision lenticule extraction (SMILE) for myopia correction. METHODS: This retrospective study enrolled 706 consecutive right eyes that underwent SMILE to correct myopia with or without astigmatism. All eyes were evaluated preoperatively and at 1 day, 1 week and 1 month postoperatively. At each follow-up visit, UDVA was transformed into a qualitative outcome on the basis of whether the postoperative UDVA had reached the preoperative CDVA. Thus, a logistic regression model with multiple variables was used to evaluate the effects of possible predictors of vision recovery. RESULTS: One month postsurgery, 96.6% of the eyes had a UDVA of 20/20 or better. Furthermore, the corrected distance visual acuity (CDVA) of 68.6% of the eyes remained unchanged, 26.2% gained one line of CDVA, and 3.3% lost one line of CDVA. Additionally, our data revealed that 90.5% of the eyes were within 0.5 diopters (D) and that 38.1% were within ± 0.13 D at 1 month after surgery. Multivariate logistic regression analysis showed that age hindered postoperative UDVA from reaching preoperative CDVA at 1 day (OR = 0.954, P < 0.001) and 1 week (OR = 0.932, P < 0.001) but had no significant effect at 1 month (OR = 0.981, P = 0.418) postoperatively. In addition, female gender hindered postoperative UDVA from reaching preoperative CDVA at 1 day (OR = 0.592, P = 0.006) and 1 week (OR = 0.631, P = 0.031) but had no significant effect at 1 month (OR = 0.669, P = 0.317) postoperatively. CONCLUSIONS: The refractive outcomes of SMILE are affected by age and sex in the early postoperative period. This study revealed that age and female sex hindered postoperative UDVA from reaching preoperative CDVA at 1 day and 1 week after surgery, but had no effect at 1 month after surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-025-04335-x.