Ten-Year Comparative Clinical Outcomes Of Femtosecond Laser–Assisted In Situ Keratomileusis (Fs-Lasik) And Keratorefractive Lenticule Extraction (Klex)
Published 2026 - 44th Congress of the ESCRS
Reference: PP10.08 | Type: Free paper | DOI: 10.82333/8ajd-w412
Authors: Dr Betul Dumlu* 1 , Dr Seda Liman Uzun 2 , Dr Selçuk Çetin 3 , Dr Gülay Yalçınkaya Çakır 2 , A/Prof. Nilay Kandemir Beşek 2 , Prof. Dr Ahmet Kırgız 2 , A/Prof. Sibel Ahmet 2 , A/Prof. Burcu Kemer Atik 2 , Dr Sevgi Tongal 2
1Ophthalmology,Beyoğlu Eye Training and Research Hospital,Istanbul,Türkiye, 2Department of Refractive Surgery,Beyoğlu Eye Training and Research Hospital,Istanbul,Türkiye, 3Ophthalmology,Bagcilar Training And Research Hospital,Istanbul,Türkiye
Purpose
The objective of this study was to evaluate and compare the long-term clinical outcomes of Femtosecond Laser–Assisted In Situ Keratomileusis (FS-LASIK) and Keratorefractive Lenticule Extraction (KLEx) over a 10-year follow-up period for the correction of myopia and myopic astigmatism.
Setting
This study was conducted at the Department of Refractive Surgery, Beyoğlu Eye Training and Research Hospital, a tertiary referral center in Istanbul, Turkey.
Methods
This retrospective study included patients who underwent FS-LASIK or KLEx procedures in or before 2015 and had regular follow-up examinations. A total of 55 eyes of 30 patients in the KLEx group and 51 eyes of 29 patients in the FS-LASIK group were included.
The following parameters were evaluated preoperatively and at the 1st, 5th, and 10th postoperative years: uncorrected distance visual acuity (UDVA), best-corrected visual acuity (BCVA), manifest refraction and spherical equivalent, corneal astigmatism derived from corneal topography, central corneal thickness (CCT), keratometry (K) values, and corneal aberrations measured within the 4-mm and 6-mm pupillary zones.
Results
At 10 years postoperatively, both UDVA and BCVA were significantly increased in both groups (p<0.001). However, no significant difference was observed in BCVA change between FS-LASIK and KLEx(p=0.095). Preoperative corneal astigmatism was 1.79±1.10D in FS-LASIK and 0.87±0.52D in KLEx, decreasing to 1.05±0.71D and 0.66±0.40D after 10 years. Mean spherical equivalent improved from −3.40±1.43D and −4.93±1.87D to −0.45±0.88D and −0.59±0.98D, respectively. ANOVA demonstrated a significant improvement in SE over time (p<0.001).Spherical, coma, and trefoil aberrations in the 6-mm pupillary zone increased significantly(p<0.05); spherical and trefoil showed similar increases in both groups, whereas coma increased more in the KLEx group(p<0.001).
Conclusions
The FS-LASIK group exhibited higher baseline astigmatism and greater astigmatic reduction compared with the KLEx group. Although both procedures resulted in substantial refractive correction, the residual spherical equivalent at the 10-year follow-up was slightly lower in the FS-LASIK group than in the KLEx group. Overall, FS-LASIK and KLEx demonstrated comparable long-term effectiveness and safety, although certain parameters showed relative advantages for one technique over the other.