Introduction: Contralateral-eye surgery provides a unique opportunity to compare different keratorefractive lenticule extraction (KLEx) platforms while minimizing patient-related confounding. Direct intraindividual comparisons of KLEx performed using the VisuMax and SCHWIND ATOS femtosecond laser platforms remain limited. This case highlights early and long-term visual and refractive outcomes after KLEx performed with 2 different femtosecond laser platforms in a single patient. Patient and Clinical Findings: A 25-year-old woman with stable bilateral myopia presented for refractive surgery evaluation. Preoperative examination revealed normal anterior and posterior segment findings, adequate corneal thickness, and symmetric corneal tomography in both eyes. Corrected distance visual acuity was 20/20 bilaterally, and no ocular or systemic comorbidities were identified. Diagnosis, Intervention, and Outcomes: The patient underwent bilateral KLEx on consecutive days. In the right eye, KLEx was performed using the VisuMax 500 femtosecond laser system, while in the left eye, KLEx was performed using the SCHWIND ATOS platform. Early postoperative interocular differences in uncorrected distance visual acuity (UDVA) and spherical equivalent were observed, with faster initial visual recovery in the ATOS-treated eye. By 6 months postoperatively, UDVA reached 20/20 in both eyes, and refractive outcomes stabilized. At 10 months, visual acuity remained stable with no evidence of refractive regression. Conclusions: This contralateral-eye case demonstrates that KLEx performed using different femtosecond laser platforms can achieve excellent and stable long-term visual outcomes. Early postoperative interocular differences may occur but tend to diminish over time, underscoring the importance of longitudinal follow-up when interpreting early postoperative results.
Yang et al. (2026) studied this question.