Primavera L, Canto-Cerdan M, Alio JL, et al. - Researchers conducted this retrospective, consecutive, comparative study to assess the influence of patient’s age at the time of surgery on small incision lenticule extraction (SMILE) refractive outcomes. They contrasted the refractive outcomes after myopic SMILE from two groups of patients divided by age (patients ≤ 35 and ≥ 40 years old). One hundred two matched eyes of 53 patients were involved. In patients over 40 years of age, although acceptable, post-SMILE refractive outcomes are not as good as those obtained in younger patients, showing significantly lower effectiveness and safety indexes, and worse astigmatic outcomes, with a tendency towards undercorrection. It is believed that the increased corneal stroma stiffness in the aged group modifies the post-SMILE corneal stroma remodelling capacity, thereby affecting the SMILE refractive and visual response.