Comparison of VISUMAX 800 and VISUMAX 500 Femtosecond Laser Systems for Myopia: A Systematic Review and Meta-Analysis.
VISUMAX 800 associated with better astigmatism axis alignment than VISUMAX 500 laser.
Comparison of VISUMAX 800 and VISUMAX 500 Femtosecond Laser Systems for Myopia: A Systematic Review and Meta-Analysis.
The VISUMAX 800 (Carl Zeiss Meditec) is the second-generation femtosecond laser for small incision lenticule extraction (small incision lenticule extraction), featuring faster pulse rates, automated cyclotorsion compensation (OcuLign), and automated centration (CentraLign) versus the VISUMAX 500.
Following PRISMA 2020 guidelines, we searched PubMed, EMBASE, and Web of Science through March 2026 for studies comparing the two platforms in myopia or myopic astigmatism with extractable data.
eyes were more likely to have correctly aligned astigmatism angle with VISUMAX 800
For SE ± 0.50 D, the pooled risk ratio (RR) was 1.065 (95% CI: 0.997-1.137, p = 0.061) with substantial heterogeneity (I 2 = 64.7%, p = 0.004).
For CYL ± 0.50 D (eight studies, 1585 eyes), the pooled RR was 1.022 (95% CI: 0.978-1.068, p = 0.333, I 2 = 51.7%).
No statistically significant differences were observed for UDVA ≥ 20/20, safety, SEQ R 2 , cylinder R 2 , TIA, SIA, total HOAs, spherical aberration, or coma RMS.
Publication bias tests showed no significant asymmetry for the primary outcomes, though these tests have limited power with fewer than 10 studies.
Both platforms yield comparable predictability, safety, and visual outcomes. VISUMAX 800 offers superior astigmatism axis alignment, likely due to automated compensation and centration.
The borderline SE predictability warrants further randomized investigation.