Primavera L, Canto-Cerdan M, Alio JL, et al. - Researchers here examined if and how a patient's age at the time of surgery affects small incision lenticule extraction (SMILE) refractive outcomes. They conducted this retrospective, consecutive, comparative study including 102 matched eyes of 53 patients. Outcomes suggest that although acceptable post-SMILE refractive outcomes are attained in patients over 40 years of age, these are not as good as those obtained in younger patients, indicating a significantly lower efficacy and safety indexes, and poorer astigmatic outcomes, with a tendency towards undercorrection. It is hypothesized that the post-SMILE corneal stroma remodelling capacity is modified by the increased corneal stroma stiffness in the aged group, thus impacting the SMILE refractive and visual response.