Journal of refractive surgery (Thorofare, N.J. : 1995) · 2026
Keratorefractive Lenticule Extraction Using a Novel Nomogram Software Tool for High Astigmatism: Refractive Outcomes and Aberrations.
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Shi Yue, Huang Tianze, Du Yifan, Jiang Yang, Li Ying, Chen Di
Аннотация
PURPOSE: To develop a VISULYZE (Carl Zeiss Meditec AG)-generated nomogram for keratorefractive lenticule extraction (KLEx) in patients with high astigmatism and to compare refractive accuracy and visual outcomes between surgeries performed with and without the nomogram.
METHODS: This study included 43 patients (57 eyes) with pre-operative refractive astigmatism of 1.50 diopters (D) or greater who underwent KLEx with the VISULYZE nomogram and 34 patients (45 eyes) in a matched control group who underwent KLEx without the nomogram. The primary outcomes were the predictability of residual astigmatism and higher order aberrations at the 3-month follow-up visit.
RESULTS: In the VISULYZE group, 98% of eyes achieved uncorrected distance visual acuity (UDVA) better than 20/20 versus 95% in the control group. UDVA equal to or better than preoperative corrected distance visual acuity (CDVA) was achieved in 98% versus 95% and residual astigmatism of 0.50 D or less occurred in 100% versus 88.9% of eyes. Correlation (R2) between attempted and achieved astigmatism was 99.49% and 98.46%, respectively. Astigmatic axis deviation within ±5 degrees occurred in 87.3% versus 60.0%. The VISULYZE group showed significantly lower total eye coma (P < .05), trefoil aberration (P < .01), anterior corneal vertical trefoil (P < .05), and posterior corneal spherical aberration (P < .05) at 3 months.
CONCLUSIONS: KLEx with the VISULYZE nomogram is safe, effective, and provides superior refractive accuracy and visual quality in eyes with astigmatism of 1.50 D or greater. Further follow-up is needed to assess long-term safety and stability.
METHODS: This study included 43 patients (57 eyes) with pre-operative refractive astigmatism of 1.50 diopters (D) or greater who underwent KLEx with the VISULYZE nomogram and 34 patients (45 eyes) in a matched control group who underwent KLEx without the nomogram. The primary outcomes were the predictability of residual astigmatism and higher order aberrations at the 3-month follow-up visit.
RESULTS: In the VISULYZE group, 98% of eyes achieved uncorrected distance visual acuity (UDVA) better than 20/20 versus 95% in the control group. UDVA equal to or better than preoperative corrected distance visual acuity (CDVA) was achieved in 98% versus 95% and residual astigmatism of 0.50 D or less occurred in 100% versus 88.9% of eyes. Correlation (R2) between attempted and achieved astigmatism was 99.49% and 98.46%, respectively. Astigmatic axis deviation within ±5 degrees occurred in 87.3% versus 60.0%. The VISULYZE group showed significantly lower total eye coma (P < .05), trefoil aberration (P < .01), anterior corneal vertical trefoil (P < .05), and posterior corneal spherical aberration (P < .05) at 3 months.
CONCLUSIONS: KLEx with the VISULYZE nomogram is safe, effective, and provides superior refractive accuracy and visual quality in eyes with astigmatism of 1.50 D or greater. Further follow-up is needed to assess long-term safety and stability.