Ryu Soyoung, Kang David S Y, Kim Kang Yoon, Arba-Mosquera Samuel, Chung Byunghoon, Jun Ikhyun, Elsheikh Ahmed, Seo Kyoung Yul, Kim Tae-Im
J Refract Surg. 2025 Jul;41(7):e635-e644. doi: 10.3928/1081597X-20250509-05. Epub 2025 Jul 1.
To compare early postoperative visual outcomes and higher order aberrations (HOAs) between plasma and conventional keratorefractive lenticular extractions (P-KLEx and C-KLEx).
In this retrospective case series, records of patients who underwent KLEx surgery using two protocols-C-KLEx (symmetric spot/track distance laser spacing, 100-nJ pulse energy, VisuMax 500; Carl Zeiss Meditec) or P-KLEx (asymmetric spot/track distance laser spacing, 85-nJ pulse energy, VisuMax 800; Carl Zeiss Meditec)-were reviewed. Both groups received an identical total energy dosage of 625 mJ/cm. Postoperative visual acuity and corneal higher order aberrations (HOAs) were analyzed at 1 day, 2 weeks, and 2 months.
Among 281 eyes, 136 and 145 were included in the C-KLEx and P-KLEx groups, respectively. At postoperative day 1, the mean uncorrected distance visual acuities (UDVAs) were 0.02 ± 0.04 and 0.01 ± 0.08 logarithm of the minimum angle of resolution (logMAR) in the C-KLEx and P-KLEx groups, respectively ( = .22); however, the P-KLEx group demonstrated significantly better mean UDVA at 2 weeks and 2 months postoperatively (both < .05). At 2 weeks postoperatively, the mean UDVAs were -0.01 ± 0.04 and -0.04 ± 0.07 logMAR in the C-KLEx and P-KLEx groups, respectively, and at 2 months postoperatively, the mean UDVAs were -0.02 ± 0.04 and -0.04 ± 0.06 logMAR, respectively. The P-KLEx group showed less induction of total HOAs, coma, and spherical aberration than the C-KLEx group (all < .05).
P-KLEx, which minimizes microcavitation and creates a lenticule with near-pure plasma, shows more favorable outcomes than C-KLEx, yielding better early postoperative visual acuities and reduced induction of corneal HOAs. .
比较等离子体与传统角膜屈光性晶状体摘除术（P-KLEx和C-KLEx）术后早期视力结果和高阶像差（HOAs）。
在这个回顾性病例系列中，回顾了使用两种方案进行KLEx手术的患者记录——C-KLEx（对称光斑/轨迹间距激光间距，100 nJ脉冲能量，VisuMax 500；卡尔蔡司医疗技术公司）或P-KLEx（非对称光斑/轨迹间距激光间距，85 nJ脉冲能量，VisuMax 800；卡尔蔡司医疗技术公司）。两组接受相同的总能量剂量625 mJ/cm²。在术后1天、2周和2个月分析术后视力和角膜高阶像差（HOAs）。
在281只眼中，C-KLEx组和P-KLEx组分别纳入136只和145只。术后第1天，C-KLEx组和P-KLEx组的平均未矫正远视力（UDVA）分别为0.02±0.04和0.01±0.08最小分辨角对数（logMAR）（P = 0.22）；然而，P-KLEx组在术后2周和2个月时平均UDVA明显更好（均P < 0.05）。术后2周时，C-KLEx组和P-KLEx组的平均UDVA分别为-0.01±0.04和-0.04±0.07 logMAR，术后2个月时，平均UDVA分别为-0.02±0.04和-0.04±0.06 logMAR。P-KLEx组比C-KLEx组诱导的总HOAs、彗差和球差更少（均P < 0.05）。
P-KLEx可将微空化降至最低并形成近乎纯等离子体的晶状体，与C-KLEx相比显示出更有利的结果，术后早期视力更好且角膜HOAs诱导减少。
