Early Clinical Outcomes Of The First Consecutive Clear Keratorefractive Lenticule Extraction (Klex) Cases Using The Femto Ldv Z8 Platform For Myopia And Myopic Astigmatism

To evaluate the early safety, efficacy, refractive predictability, and higher-order aberrations (HOAs) induction of the first consecutive CLEAR Keratorefractive Lenticule Extraction (KLEx) cases performed with the low energy FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems) for the correction of myopia and myopic astigmatism.

A single-center, retrospective, consecutive case series conducted at Dar al Oyoun hospital, Cairo, Egypt.

This retrospective consecutive case series included 50 eyes of 26 patients (mean age 29.7 ± 6.7 years) undergoing KLEx CLEAR for myopia or compound myopic astigmatism. Primary outcomes included Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), Spherical Equivalent Refraction (SEQ), refractive predictability, and residual astigmatism at 1 week, 1 month, and 3 months postoperatively. Total HOAs including spherical aberration (SA) was assessed preoperatively and at 1 month postoperatively.  

Preoperatively, the mean sphere was -1.72 ± 1.40 diopters (D) (range: -0.50 to -7.00 D), the mean cylinder was -1.29 ± 0.95 D (range: 0.00 to -3.25 D), and the Spherical Equivalent Refraction (SEQ) was -2.36 ± 1.23 D (range: -1.13 to -7.00 D).

At 1 week postoperatively, the mean SEQ was 0.02 ± 0.52 D, and at 1 month 0.05 ± 0.32 D. At 3 months, 89.3% of eyes were within ±0.50 D of the intended correction, and 100% of eyes were within ±1.00 D. Residual astigmatism was 0.15 ± 0.14 D of cylinder, with 100% of eyes within ±0.50 D. UDVA was 20/20 or better for 93.9% of eyes. The safety index was 1.07 at 3 months, and no eye had lost any line of CDVA.Total HOAs increased from 0.08 ± 0.03 µm to 0.12 ± 0.03 µm.

In this initial surgical experience, KLEx using the low energy FEMTO LDV Z8 CLEAR platform demonstrated favorable early safety, efficacy, and predictability for the correction of myopia and myopic astigmatism while inducing only minimal HOAs.