Subjective and Objective Visual Quality Outcomes After KLEx vs KLEx Xtra: A 2-Year Prospective Randomized Trial.

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Refractive surgery aims to correct vision errors like myopia.
• Keratorefractive lenticule extraction (KLEx) is a surgical technique for vision correction.
• Corneal cross-linking (CXL) strengthens the cornea and is often combined with refractive procedures.

Purpose of the Study:

• To compare the 2-year refractive outcomes and visual quality of KLEx versus KLEx combined with CXL (KLEx Xtra).

Main Methods:

• 150 myopic patients underwent either KLEx or KLEx Xtra surgery.
• Refractive stability and objective/subjective visual quality were assessed over 24 months.
• Corneal cross-linking energy was standardized at 2.4 J/cm².

Main Results:

• KLEx Xtra demonstrated superior refractive stability at 24 months (p < .05).
• Transient increases in higher-order aberrations post-KLEx Xtra resolved by 6 months.
• No significant differences in subjective visual quality were found between groups at 24 months, except for glare.

Conclusions:

• KLEx Xtra enhances long-term refractive stability compared to KLEx alone.
• The combined procedure does not detrimentally affect visual quality.
• KLEx Xtra is a suitable option for patients with borderline risk profiles.