Next-Generation Klex With Low-Energy Dose: Early Visual Outcomes From Day One
Published 2026 - 44th Congress of the ESCRS
Reference: POREF075 | Type: Free paper | DOI: 10.82333/9nfz-4g77
Authors: Dr Juan Arbelaez* 1 , Ms Nicole Suarez 2
1Cornea and Refractive Surgery,The Eye Clinic,Medellin,Colombia, 2Optometry,The Eye Clinic,Medellin,Colombia
Purpose
To evaluate the early safety, efficacy, and visual and refractive outcomes following low-energy dose KLEx using asymmetric spacing spot/track distances for the correction of myopia, myopic astigmatism, and pure astigmatism using a femtosecond laser system equipped with eye-tracking, precise centration, cyclotorsion compensation, and the asymmetric transition zone centration strategy (Centrax).
Setting
This clinical study was conducted at The Eye Clinic, a private ophthalmic surgery center in Medellin, Colombia.
Methods
This prospective observational study included 46 eyes that underwent low-energy dose SmartSight NOVA using the SCHWIND ATOS femtosecond laser (dose range: 396–462 mJ/cm²). All procedures were performed by a single surgeon (JA). MS-39 tomography and biometry, PERAMIS ocular aberrometry, visual acuity, and manifest refraction were evaluated preoperatively, at postoperative day 1, and at 3 months.
Results
Mean SEQ was −2.24±1.64D (range 0.00 to −5.75), and mean cylinder was −1.42±0.99D (up to −3.50). Mean lenticule thickness was 86.5±20.34µm (range 47–124). Treatments were performed using 9mm diameter caps with 120µm thickness, and lenticules were removed through a single 2 mm incision. Mean optical zone was 7.1±0.33mm (range 6.3–7.3), and mean total lenticule diameter was 7.8±0.3mm (range 7.1–8.1). At postoperative day 1, mean SEQ was +0.01±0.09D (range −0.25 to +0.50), with 100% of eyes within ±0.50D. Mean postoperative cylinder was −0.02±0.09D, with 100% ≤0.50D and 98% ≤0.25D. UDVA was equal to or better than preoperative CDVA in 100% of eyes, and 61% gained ≥1 line. No eyes lost lines of CDVA.
Conclusions
Low-energy dose SmartSight NOVA with Centrax and using asymmetric spacing spot/track distances demonstrated excellent early safety, efficacy, and refractive accuracy. At postoperative day 1, 100% of eyes achieved UDVA ≥ preoperative CDVA, with 61% gaining ≥1 line and no loss of CDVA observed. These findings suggest that this next-generation KLEx approach provides highly encouraging early visual and refractive outcomes.