Safety And Efficacy Of Clear (Corneal Lenticule Extraction For Advanced Refractive Surgery) In Myopia And Astigmatism Correction: A Retrospective Analysis Of Visual And Refractive Outcomes
Published 2025 - 43rd Congress of the ESCRS
Reference: PP12.14 | Type: Free paper
Authors: Ashmal Jameel* 1 , Vijay Wagh 2 , Scott Robbie 2 , Sancy Low 2 , Maninder Bhogal 2 , Elodie Azan 2 , Seema Verma 2 , David O'Brart 1
1Ophthalmology,St Thomas' Hospital,London,United Kingdom;King's College London,London,United Kingdom, 2Ophthalmology,St Thomas' Hospital,London,United Kingdom
Purpose
This study aims to evaluate the safety and efficacy of the CLEAR (Corneal Lenticule Extraction for Advanced Refractive Surgery), a KLEX (Keratorefractive Lenticule Extraction) procedure, by analyzing visual outcomes at different postoperative time points.
Setting
This study was conducted at Centro de Estudos H. Olhos São Gonçalo, located in the state of Rio de Janeiro, Brazil, between August 2024 and February 2025. All patients provided informed consent, Informed Consent Form (ICF), before participation. All procedures adhered to the Declaration of Helsinki.
Methods
A retrospective analysis was conducted on 44 eyes undergoing the CLEAR procedure using the FEMTO LDV Z8 laser. Key parameters, including uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), were assessed at three intervals postoperatively: day 1, day 7, and day 30. The study examined the mean and range of refractive outcomes and the number of eyes experiencing visual loss or improvement compared to preoperative CDVA. Patients included in the study had myopia ranging from -1.00 to -10.00 D and astigmatism ≤ 3.00 D. They were aged between 18 and 45 years and had documented refractive stability for at least 12 months prior to the procedure.
Results
The mean refractive outcome was highly predictable (-0.04±0.02 D; range: -0.01 to -0.09 D). At postoperative day 1, 50% achieved UDVA of 20/20 or better, increasing to 72.7% by day 30. CDVA loss was minimal, with 4.5% losing three or more lines and 11.4% losing two. Spherical error improved from -5.50 ± 1.20 D to -0.30 ± 0.20 D, with 90% within ±0.50 D of target. Residual error averaged -0.20 ± 0.10 D, with 80% achieving UDVA of 20/25 or better. Astigmatism stability improved over time, and the safety and efficacy indices ranged from 0.98 to 1.02 and 0.95 to 1.00, respectively.
Conclusions
The analyzed procedure demonstrated a favorable efficacy and safety profile, with the majority of eyes achieving excellent visual acuity outcomes. These findings support its reliability as an effective refractive surgical option.