To evaluate the efficacy, safety, and predictability of Keratorefractive Lenticule Extraction (KLEx) surgery guided by a VISULYZE-generated nomogram for myopia and astigmatism correction. This prospective cohort study included 130 consecutive patients (260 eyes) undergoing KLEx surgery using a VISULYZE-generated nomogram. Patients were followed for 3 months postoperatively. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent (SE). "Nine Standard Graphs" were generated using VISULYZE software and analyzed according to international standards for evaluating the quality of corneal refractive surgery. Subgroup analyses based on age (≤30 years vs >30 years) and preoperative SE (≤-6.00 D vs >-6.00 D) were performed. At 3 months postoperatively, 96% of eyes achieved UDVA of 20/20 or better, and 96.2% maintained or improved CDVA compared to preoperatively. No eyes lost 1 or more lines of CDVA. The correlation coefficient (R²) between attempted and achieved SE was 0.9732. 98.1% of eyes were within ±0.50 D of the attempted SE. 99.2% of eyes achieved a postoperative cylinder ≤0.50 D. Subgroup analysis revealed that older patients (>30 years) had slightly lower UDVA compared to younger patients, while high myopes (≤-6.00 D) showed a trend towards slight under-correction and lower efficacy compared to moderate and low myopes. However, astigmatism correction was comparable between subgroups. KLEx surgery guided by a VISULYZE-generated nomogram demonstrates excellent efficacy, safety, and predictability for myopia and astigmatism correction. While age and preoperative myopia degree may subtly influence efficacy, the nomogram provides a valuable tool for personalized surgical planning. Further research is warranted to refine nomogram development, particularly for older and highly myopic patients.
Wan et al. (Fri,) studied this question.