Corneal Lenticule Extraction For Advanced Refractive Correction (Clear) Surgery After Primary Clear Treatment.

To report visual and refractive outcomes of five cases of enhancement procedure with Corneal Lenticule Extraction for Advanced Refractive Correction (CLEAR) surgery after primary CLEAR treatment.

Retrospective case series, First Samsung Eye Center, Seoul, Republic Of Korea.

Five eyes (1 left eye, 4 right eyes) of 4 patients underwent a CLEAR enhancement procedure to treat residual, correctable, myopic refractive error after primary CLEAR surgery. The thickness of the lenticule cap was intended to be 30 μm thicker than the primary CLEAR treatment and the 2.0-mm lenticule access incision was created 30° superior from the initial incision. The low energy FEMTO LDV Z8 (Ziemer Ophthalmic Systems AG) built-in optical coherence tomography (OCT) was used to ensure a precise intraoperative geometrical positioning of the lenticule enhancement procedure cut under the primary treatment interface. Postoperative assessments were performed at 1 day, 1 week, 1 month and 2 months after the surgery.

At two months after the enhancement procedure, uncorrected distance visual acuity (UDVA) ranged from 1.0 decimal to 1.5 decimal in four eyes, except for one. The myopic residual refractive sphere error was removed in all eyes.

CLEAR enhancement procedure for the correction of myopic residual refractive error after a primary CLEAR treatment was a safe and effective procedure. The FEMTO LDV Z8 integrated spectral domain OCT and the stable suction allowed for an effective positioning of the CLEAR enhancement procedure, which enabled accurate refractive outcomes and fast visual recovery.