Utilising VISULYZE-Generated Nomograms and OcuLign Alignment Tools to Improve Keratorefractive Lenticule Extraction Outcomes.

Background

The keratorefractive lenticule extraction (KLEx) procedure has gained popularity because of its safety and effectiveness; however, its predictability remains variable, as it may be over- or under-corrected. This study aimed to evaluate visual and refractive outcomes following the utilisation of VISULYZE-generated nomograms (Carl Zeiss Meditec AG, Jena, Germany) and OcuLign cyclotorsion alignment tools (Carl Zeiss Meditec AG, Jena, Germany).

Methods

This retrospective consecutive cohort study included patients undergoing KLEx, grouped into four sequential treatment phases: PRE-NOMOGRAM, NOMOGRAM, OCULIGN & NOMOGRAM, and OCULIGN.

Results

A total of 688 patients (1264 eyes) were included. The OCULIGN group showed numerically higher efficacy, with 83.0% achieving post-operative (PO) uncorrected distance visual acuity (UDVA) 20/20 or better, with no loss of corrected distance visual acuity (CDVA) lines, and 67.0% gaining one line. Predictability and accuracy were high across groups, with the OCULIGN group demonstrating a strong correlation between attempted and achieved spherical equivalent (R2 = 0.9908), and 95.5% of eyes within ±0.50 D. Early PO outcomes suggested minimal refractive shift at one month. The NOMOGRAM group demonstrated numerically improved astigmatism correction (100.0% within ≤0.50 D), while the OCULIGN & NOMOGRAM group showed high precision in axis alignment. However, baseline imbalances were present, and between-group differences were relatively small.

Conclusions

The use of OcuLign cyclotorsion alignment and VISULYZE-generated nomograms was associated with favourable visual and refractive outcomes following KLEx. However, given the retrospective, sequential design, imbalanced baseline, and limited follow-up duration, these findings should be interpreted cautiously. Further prospective, randomised studies with longer follow-up are required to confirm these observations.