ESCRS - FP14.06 - First In Human Klex For Simple Myopic Astigmatism

First In Human Klex For Simple Myopic Astigmatism

Published 2025 - 43rd Congress of the ESCRS

Reference: FP14.06 | Type: Free paper | DOI: 10.82333/g169-f027

Authors: Hyeck Soo Son* ¹ , Emilia Felter ¹ , Maximilian Friedrich ¹ , Victor Augustin ¹ , Gerd U. Auffarth ¹

¹University of Heidelberg,Heidelberg,Germany

Purpose

This study aimed to evaluate the feasibility and safety of performing keratorefractive lenticule extraction for simple myopic astigmatism using the Schwind ATOS Femtosecond laser with integrated static cyclotorsion correction. A total of 44 eyes were treated and followed for three months. By eliminating the creation of a corneal flap, we sought to reduce flap-related complications common in high-cylinder LASIK procedures. Our goal was to determine whether this novel, flapless technique delivers precise astigmatic correction and offers a safe alternative to conventional corneal refractive methods.

Setting

Eye clinic Svjetlost, Zagreb, Croatia

Methods

Patients with no spherical component after full cycloplegic refraction were included. Preoperative measurements were obtained using the CSO MS39, and automatic compensation for cyclotorsion was applied. All surgeries were performed by a single experienced surgeon (IG) using the Schwind ATOS Femtosecond laser. Postoperative evaluations were conducted at one week, one month, and three months to assess visual acuity and residual astigmatism.

Results

On postoperative day one, all treated eyes achieved better than 20/25 visual acuity. The average preoperative cylinder was −2.96 D (range −1.0 D to −6.0 D). By one month and three months, all patients had an uncorrected distance visual acuity of 20/20 or better. The mean residual cylinder was 0.28 D (range 0.0 to 0.75 D), indicating a high degree of refractive accuracy and stability.

Conclusions

Keratorefractive lenticule extraction using the Schwind ATOS with static cyclotorsion correction proves to be a safe and effective option for correcting simple myopic astigmatism. Its flapless nature reduces potential flap-related complications, which can be problematic in high-cylinder LASIK cases. Our findings demonstrate precise correction and excellent visual outcomes at three months, suggesting this technique is a viable alternative for patients with purely cylindrical refractive errors.