We compared the visual and refractive results between 2 different incisional sites in small incision lenticule extraction (SMILE) for low myopic astigmatism. the logMAR uncorrected distance visual acuity was 0.074??0.090 in Group 1 and 0.084??0.130 in Group 2 (p?=?0.861). No difference was found in the postoperative manifest spherical equivalent (p?=?0.501) and manifest cylinder (p?=?0.178) between the 2 groups. The efficacy index was 0.85??0.16 in Group 1 and 0.85??0.20 in Group 2 (p?=?0.828). Astigmatic correction was not significantly affected by the location of opening incisions using vector analysis. Our study did not find significant differences in visual and refractive outcomes with temporal or superior opening 55721-31-8 manufacture incision during SMILE surgery. Femtosecond laser has been used to create thin and uniform flaps in laser assisted keratomileusis (LASIK) with great precision1,2. The use of femtosecond laser has recently been extended to a new type of corneal refractive treatment termed refractive lenticule removal. Based on the meant refractive correction, a thin lenticule was cut with femtosecond laser beam and was removed subsequently. Small-incision lenticule removal (SMILE) represents the technique where the lenticule can be eliminated through the creation of 1 or more little peripheral corneal incisions3,4. Different research possess proven that SMILE can be safe and 55721-31-8 manufacture effective for corneal refractive correction of myopia and astigmatism5,6,7,8,9. Treatment parameters vary amongst studies utilizing SMILE for myopic correction10. Scanning trajectory of the femtosecond laser has been shown to affect early visual recovery and refractive outcomes after SMILE11. On the other hand, visual performance and optical quality were not affected by energy settings of the femtosecond laser12. The peripheral corneal incision, through which the lenticule is extracted, was also not standardized. More than one opening incisions have been used3,6, while most studies had the lenticule extracted through a single superior opening4,5,11,13,14. The size of the incision also varied amongst or within studies6,7,13. To our knowledge, no studies have tried to investigate the effect of incisional location on the refractive outcomes of SMILE. The purpose of this study aims to compare the visual and refractive outcomes between 2 different incisional sites in SMILE for low myopic astigmatism. Low cylinder correction was chosen because the opening incision is usually only 100 to 140?m in depth10, its potential effect could be masked by a high magnitude of astigmatic correction. Results This was a contralateral eye comparative study. Twenty-nine patients with a mean age of 35.0??9.6 years were included. The peripheral incision was located at the temporal cornea for the right eye (Group 1) and at the superior corneal for the left eye (Group 2) for each patient. There was no significant difference in manifest spherical equivalent (p?=?0.279), manifest sphere (p?=?0.250), manifest cylinder (p?=?0.465) and uncorrected distance visual acuity (CDVA) (p?=?1.000) between the 2 groups preoperatively (Table 1). All surgeries were uneventful without any intraoperative complications. Table 1 Preoperative and postoperative characteristics of patients undergoing small-incision lenticule extraction with a temporal (Group 1) or superior (Group 2) opening incision. At 3 months, the logMAR corrected distance visual acuity (CDVA) was 0.015??0.029 in Group 1 and 0.012??0.032 in Group 2 (p?=?0.564). The logMAR UDVA was 0.074??0.090 in Group MLLT3 1 and 0.084??0.130 in Group 2 (p?=?0.861). No significant difference was found in the postoperative manifest spherical equivalent (p?=?0.501), manifest sphere (p?=?0.910) and manifest cylinder (p?=?0.178) between the 2 groups (Table 1). Seventeen (58.6%) eyes in Group 1 were with??0.25 Diopter (D) of the attempted cylindrical correction at 3 month. The corresponding worth in Group 2 was 21 (72.4%) eye (p?=?0.269) (Fig. 1). Shape 1 Distribution of refractive astigmatism in diopters (D) before (gray) and after (white) small-incision lenticule removal having a temporal 55721-31-8 manufacture (Group 1) or excellent (Group 2) starting incision. The effectiveness index, that was determined as the percentage of postoperative UDVA over preoperative CDVA, was 0.85??0.16 in Group 1 and 0.85??0.20 in Group 2 (p?=?0.828). The protection index, that was established as the percentage of postoperative CDVA over preoperative CDVA, was 0.96??0.08 in Group 1 and 0.97??0.07 in Group 2 (p?=?0.799). No postoperative corneal problem, such as for example wound dehiscence, infection and inflammation, was seen in any individual. Vector evaluation The vector evaluation outcomes using the 3-month refractive data are demonstrated in Desk 2. There is no factor in the arithmetic mean of focus on induced astigmatism (TIA), surgically induced astigmatism (SIA), difference vector (DV) and magnitude of mistake (Me personally) between.