Visual And Refractive Outcomes And Accuracy In Low Versus High Astigmatism Of Myopic Astigmatism Treatment With Corneal Lenticule Extraction For Advanced Refractive Correction (Clear)

To present the visual and refractive outcomes of myopic astigmatism treatment with corneal lenticule extraction for advanced refractive correction (CLEAR) and assess accuracy in low versus high astigmatism.

190 consecutive eyes of 106 patients with myopic astigmatism who underwent kerato-retractive lenticule extraction (KLEx) with CLEAR using the FEMTO LDVZ8 platform (Ziemer Ophthalmic Systems)

This is a retrospective analysis of 190 consecutive eyes of 106 patients with myopic astigmatism who underwent kerato-retractive lenticule extraction (KLEx) with CLEAR using the FEMTO LDVZ8 platform (Ziemer Ophthalmic Systems). Patients were treated from January 2024 to June 2025 at the Central Seoul Eye Center, Seoul, South Korea. Visual outcomes were evaluated at 1-day, thereafter visual and refractive outcomes were evaluated at 1-day, 1-week, 1-month and 3-months postoperatively.

The mean preoperative sphere was −3.99 ± 1.57 D (range −0.50 to −7.75 D), the mean cylinder −1.31 ± 0.84 D (range −0.25 to −4.75 D) and the mean spherical equivalent −4.65 ± 1.66 D (range −0.88 to −9.13 D). At 3-months postoperatively, 97.9% of eyes achieved 20/25 or better uncorrected visual acuity and 93.2% achieved 20/20 or better uncorrected visual acuity. Manifest spherical equivalent was within ±0.50 D in 97.9% of eyes and cylinder was within ±0.50 D in 99.5% of eyes. The mean residual cylinder was −0.10 ± 0.20 D and did not differ significantly between low (≤1.50 D) and high (>1.50 D) magnitudes of treated cylinder (−0.09 ± 0.19 D and −0.13 ± 0.21 D residual cylinder respectively, P = 0.376).

CLEAR lenticule extraction with the FEMTO LDVZ8 demonstrates safe, effective, and accurate outcomes for patients with myopic astigmatism regardless of the treated cylinder magnitude.