Family and sexual functioning among women diagnosed with cervical cancer in Urban Ghana: A mixed-methods study.

The field of refractive surgery has advanced rapidly over the past decade. Flapless lenticule-based procedures, such as small incision lenticule extraction (SMILE) and keratorefractive lenticule extraction, are now widely used in clinical practice because of their well-established efficacy and safety. Since its introduction on the first-generation VISUMAX 500 platform, SMILE has become an important surgical option for the correction of myopia and myopic astigmatism. Despite the important role of the first-generation VISUMAX 500 platform in supporting the global adoption of SMILE, several intraoperative drawbacks have remained, including a relatively longer laser scanning time, susceptibility to suction loss, absence of active eye tracking, and lack of integrated cyclotorsion compensation. These factors may affect centration accuracy and postoperative optical quality. These issues are especially relevant for astigmatic correction. Prior comparative studies suggest that without static cyclotorsion compensation and automated centration guidance, SMILE depends on additional alignment methods, such as cross-hair-assisted positioning, to reduce axis errors; residual astigmatism may be lower than after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) or transepithelial photorefractive keratectomy, whereas axis correction accuracy appears to be similar across procedures. These findings indicate that rotational alignment and centration control are relevant considerations for astigmatic correction, although whether integrated platform-level guidance translates into superior clinical outcomes requires comparative evidence. The new generation VISUMAX 800 (Carl Zeiss AG, Jena, Germany) introduced in 2021, maintains the optical path and lenticule design while increasing the repetition rate to 2 MHz and adding centration support during docking (CentraLign) and intraoperative pattern rotation for cyclotorsion compensation (OcuLign); These updates have been described within the SMILE Pro software framework; the 2-MHz pulse rate markedly shortens laser delivery, which may reduce suction-loss risk related to small patient movements during suction and improve the overall workflow efficiency. CentraLign and OcuLign provide real-time image-guided support for centration and astigmatic axis alignment, which is intended to support workflow consistency and intraoperative alignment. However, favourable outcomes in a single-arm cohort cannot establish whether these platform features provide measurable advantages over earlier systems or alternative refractive procedures. The VISUMAX 800 received US Food and Drug Administration approval in 2024, which supports its wider use in routine clinical practice. Clinical evidence supporting the new-generation platforms is accumulating. Retrospective single-centre studies have reported the refractive and visual outcomes of VISUMAX 800 for correcting compound myopic astigmatism that suggest favourable refractive accuracy and safety, with potential advantages in intraoperative workflow efficiency and alignment control. A multicentre post-market clinical follow-up study demonstrated that keratorefractive lenticule extraction performed with VISUMAX 800 achieves good refractive accuracy and visual recovery in routine clinical populations while adhering to international ethical standards and International Organization for Standardization-compliant clinical research requirements. Large-scale retrospective studies with Asian populations have also reported its excellent safety, efficacy, and predictability, highlighting the importance of obtaining real-world evidence from regions with a high prevalence of myopia and myopic astigmatism.