Two-Year Results Of Corneal Lenticular Extraction For Advanced Refractive Correction (Clear) For Myopia

To report the two-year visual and refractive outcomes of patients undergoing Corneal Lenticular Extraction for Advanced Refractive correction (CLEAR), a keratorefractive lenticular extraction procedure for myopia.

Memira by Bergman Clinics, Copenhagen, Denmark

This retrospective, non-randomized, single-centre study analyses the visual and refractive outcomes, and efficacy and safety of the CLEAR procedure in 218 eyes of 109 patients with an average age of 31 years (range 18-42 years) who underwent surgery between 10/2023 and 11/2025. Surgery was performed using the Femto LDV Z8 by Ziemer Ophthalmic Systems AG (Switzerland). Cases where mild unilateral myopia was targeted to postpone presbyopia were excluded from analysis, as were cases where a 3-month follow-up had not been performed yet. Follow-up examinations conducted on mean 97 days (range 45-142 days) after surgery included measurement of distance visual acuity without correction (UDVA) and with correction (CDVA), and subjective refraction.

The preoperative spherical equivalent (SEQ) was -3.46 (range -1.75 to -7.13) diopters (D). The mean preoperative CDVA was 1.0 or better in all eyes. At follow-up, the mean SEQ was -0.01 (SD 0.32). The SEQ was within +/- 0.25 D in 167 eyes (77%) and +/-0.50 in 204 eyes (94%). In the first 50 eyes of 25 patients, SEQ was within +/- 0.25 D in 42 eyes (84%) and +/-0.50 in 49 eyes (98%). The mean residual cylinder was -0.33 D (SD 0.33) with 134 eyes (61%) and 187 eyes (86%) achieving equal to or less than 0.25 D and 0.50 D, respectively. Binocular UDVA was equal or more than 0.8 in 214 patients (98%) and equal to or more than 1.0 in 206 patients (94%). The safety index was 0.97 (SD 0.14) and the efficacy index was 0.90 (SD 0.18).

The CLEAR procedure achieves excellent visual and refractive outcomes in myopia while maintaining high safety and efficacy.