Wan Qi, Wei Ran, Tang Jing, Deng Ying-Ping, Ma Ke
Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu City, Sichuan Province, People's Republic of China.
Clin Ophthalmol. 2025 Aug 27;19:2985-2995. doi: 10.2147/OPTH.S551923. eCollection 2025.
To evaluate the efficacy, safety, and predictability of Keratorefractive Lenticule Extraction (KLEx) surgery guided by a VISULYZE-generated nomogram for myopia and astigmatism correction.
This prospective cohort study included 130 consecutive patients (260 eyes) undergoing KLEx surgery using a VISULYZE-generated nomogram. Patients were followed for 3 months postoperatively. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent (SE). "Nine Standard Graphs" were generated using VISULYZE software and analyzed according to international standards for evaluating the quality of corneal refractive surgery. Subgroup analyses based on age (≤30 years vs >30 years) and preoperative SE (≤-6.00 D vs >-6.00 D) were performed.
At 3 months postoperatively, 96% of eyes achieved UDVA of 20/20 or better, and 96.2% maintained or improved CDVA compared to preoperatively. No eyes lost 1 or more lines of CDVA. The correlation coefficient (R²) between attempted and achieved SE was 0.9732. 98.1% of eyes were within ±0.50 D of the attempted SE. 99.2% of eyes achieved a postoperative cylinder ≤0.50 D. Subgroup analysis revealed that older patients (>30 years) had slightly lower UDVA compared to younger patients, while high myopes (≤-6.00 D) showed a trend towards slight under-correction and lower efficacy compared to moderate and low myopes. However, astigmatism correction was comparable between subgroups.
KLEx surgery guided by a VISULYZE-generated nomogram demonstrates excellent efficacy, safety, and predictability for myopia and astigmatism correction. While age and preoperative myopia degree may subtly influence efficacy, the nomogram provides a valuable tool for personalized surgical planning. Further research is warranted to refine nomogram development, particularly for older and highly myopic patients.
评估由VISULYZE生成的列线图引导的角膜屈光透镜切除术(KLEx)治疗近视和散光的有效性、安全性及可预测性。
这项前瞻性队列研究纳入了130例连续接受使用VISULYZE生成的列线图进行KLEx手术的患者(260只眼)。术后对患者进行3个月的随访。主要观察指标为未矫正远视力(UDVA)、矫正远视力(CDVA)和等效球镜度(SE)。使用VISULYZE软件生成“九标准图”,并根据评估角膜屈光手术质量的国际标准进行分析。根据年龄(≤30岁与>30岁)和术前SE(≤-6.00 D与>-6.00 D)进行亚组分析。
术后3个月时,96%的眼达到20/20或更好的UDVA,与术前相比,96.2%的眼维持或提高了CDVA。没有眼的CDVA下降1行或更多。预期SE与实际SE之间的相关系数(R²)为0.9732。98.1%的眼的SE在预期SE的±0.50 D范围内。99.2%的眼术后柱镜度≤0.50 D。亚组分析显示,老年患者(>30岁)的UDVA略低于年轻患者,而高度近视患者(≤-6.00 D)与中度和低度近视患者相比,有轻微欠矫和疗效较低的趋势。然而,各亚组之间的散光矫正效果相当。
由VISULYZE生成的列线图引导的KLEx手术在近视和散光矫正方面显示出优异的有效性、安全性和可预测性。虽然年龄和术前近视度数可能会对疗效产生微妙影响,但列线图为个性化手术规划提供了有价值的工具。有必要进一步研究以完善列线图的开发,特别是针对老年和高度近视患者。