Xia Fei, Chen Zhuoyi, Han Xiaosong, Yu Yanze, Li Meiyan, Zhao Jing, Zhou Xingtao
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Key Laboratory of Myopia and Related Eye Diseases, NHC, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
J Ophthalmol. 2025 Aug 13;2025:9935745. doi: 10.1155/joph/9935745. eCollection 2025.
To explore the long-term (13-year) outcomes associated with keratorefractive lenticule extraction (KLEx) among patients with myopia up to -10 dioptres. This prospective, nonconsecutive case series included 29 patients (29 eyes) who underwent KLEx procedures from May, 2010, through March, 2013, at the Fudan University Eye and ENT Hospital. Analyses performed preoperatively and at the 1-month, 1-year, 5-year, 10-year, and 13-year postoperative time points included measures of uncorrected and corrected distance visual acuity (UDVA and CDVA), objective and manifest refractions, intraocular pressure, axis length, slit-lamp examination, and corneal tomography. All surgeries were performed without any complications. A UDVA of at least 20/25 was achieved in 29 eyes (100%), while 10 eyes (43.4%) exhibited unchanged CDVA, and no lines were lost for any eyes. Additionally, 21 eyes (72%) and 28 eyes (97%) were, respectively, within ±0.5 D and ±1.00 D of the target refraction. The mean refractive regression from 1 month to 13 years after surgery was -0.26 ± 0.41 D. No significant changes in posterior central elevation (PCE) or △PCE were noted at the follow-up time points (all > 0.05). Significant postoperative increases in higher-order aberrations and vertical coma were observed postoperatively ( < 0.001), and these remained largely stable over the follow-up period (all > 0.05). These 13-year follow-up results highlight the safety, stability, and predictability of KLEx as an approach to treating myopia up to -10 dioptres.
探讨近视度数达-10屈光度的患者接受角膜屈光透镜切除术（KLEx）后的长期（13年）效果。这项前瞻性、非连续性病例系列研究纳入了29例患者（29只眼），他们于2010年5月至2013年3月在复旦大学附属眼耳鼻喉科医院接受了KLEx手术。术前以及术后1个月、1年、5年、10年和13年时间点进行的分析包括未矫正和矫正远视力（UDVA和CDVA）测量、客观验光和显验光、眼压、眼轴长度、裂隙灯检查以及角膜地形图检查。所有手术均无任何并发症。29只眼（100%）的UDVA至少达到20/25，而10只眼（43.4%）的CDVA无变化，且所有眼均未丢失视力行数。此外，21只眼（72%）和28只眼（97%）分别在目标屈光度的±0.5 D和±1.00 D范围内。术后1个月至13年的平均屈光回退为-0.26±0.41 D。在随访时间点，后极中央高度（PCE）或△PCE均无显著变化（均>0.05）。术后观察到高阶像差和垂直彗差有显著增加（<0.001），且在随访期间这些指标基本保持稳定（均>0.05）。这些13年的随访结果凸显了KLEx作为一种治疗近视度数达-10屈光度的方法的安全性、稳定性和可预测性。
