Six-Month Clinical Outcomes Of Low Myopia Correction With Corneal Lenticule Extraction For Advanced Refractive Correction (Clear)

Purpose: To assess the safety, efficacy, and refractive outcomes of keratorefractive lenticule extraction (KLEx) using the FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems) for the treatment of low myopia.

Setting: A retrospective, single-surgeon, consecutive case-series study conducted at Silmäsairaala Pilke Eye Clinics in Tampere, Vaasa, and Turku, Finland.

Methods: This retrospective analysis included 143 eyes of 84 patients (30.3 ± 5.0 years old, range 20 to 38) who underwent KLEx for low myopia up to -2.00 D sphere or compound myopic astigmatism using the low-energy FEMTO LDV Z8 CLEAR application. Visual and refractive outcomes were evaluated at 1 and 6 months postoperatively.

Results: Preoperatively, the mean sphere was -1.35 ± 0.48 diopters (D) (range: -2.00 to -0.50 D), the mean cylinder was -0.72 ± 0.56 D (range: -3.25 to 0.00 D), and the spherical equivalent refraction (SEQ) was -1.76 ± 0.56 D (range: -3.13 to -0.75 D). At 1 month postoperatively, the mean SEQ was 0.03 ± 0.32 D, and 0.03 ± 0.26 D at 6 months. At 6 months, 95.1% of eyes were within ±0.50 D of the intended correction, and 100% were within ±1.00 D. Eyes with preoperative sphere between -0.50 and -1.00 D had a residual sphere of  0.20 ± 0.26 D, while eyes with preoperative sphere between for -1.01 and -2.00 D had a residual sphere of 0.22 ± 0.27 D.

Conclusions: CLEAR (KLEx using the FEMTO LDV Z8 platform) provides safe, predictable, and effective outcomes for the correction of low myopia and compound myopic astigmatism. The results align with established lenticule extraction and femtosecond laser–assisted procedures, supporting the viability of CLEAR as a treatment option for low myopic refractive errors.