Topogrpahic Changes After Klex For Simple Myopic Astigmatism
Published 2025 - 43rd Congress of the ESCRS
Reference: PO709 | Type: Free paper | DOI: 10.82333/r2qs-1988
Authors: Moreno Piaia* 1 , Umberto Rodella 2 , Laura Giurgola 2 , Claudio Gatto 2 , Jana Tothova 2 , Stefano Ferrari 3 , Diego Ponzin 3 , Alessandro Ruzza 3
1Veneto Eye Bank Foundation,Venice,Italy;university of Ferrara,Ferrara,Italy, 2AL.CHI.MI.A. S.R.L,Ponte San Nicolò,Italy, 3Veneto Eye Bank Foundation,Venice,Italy
Purpose
This study evaluated the corneal topographical changes and coupling effect after keratorefractive lenticule extraction for pure 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 flap creation, we sought to reduce potential flap-induced variables that could affect corneal shape. We aimed to determine whether this flapless approach provides precise correction of cylindrical error, stable corneal topography, and a consistent coupling effect postoperatively.
Setting
Eye clinic Svjetlost, Zagreb, Croatia
Methods
Patients selected for surgery had no spherical component after full cycloplegic refraction. All topographical measurements were obtained using the CSO MS39, which also provided automatic cyclotorsion compensation. The same experienced surgeon (IG) performed all procedures with the Schwind ATOS laser. Corneal topography was assessed at one week, one month, and three months to evaluate changes in curvature, axis alignment, and coupling effect.
Results
All eyes achieved better than 20/25 vision on postoperative day one. The mean preoperative cylinder was −2.96 D (range −1.0 to −6.0 D). At one and three months, all patients had an uncorrected distance visual acuity of 20/20 or better, with a mean residual cylinder of 0.28 D (range 0.0 to 0.75 D). Topography revealed minimal alterations in overall corneal shape, suggesting a favorable coupling effect that maintained stable spherical power while correcting astigmatism effectively.
Conclusions
Keratorefractive lenticule extraction with static cyclotorsion correction is both safe and effective for addressing simple myopic astigmatism, offering stable corneal topography and a reliable coupling effect. The flapless nature of the procedure reduces risks associated with flap adaptation and helps preserve corneal integrity. These findings suggest this approach provides precise and consistent outcomes for cylindrical refractive errors.