Keratorefractive Lenticule Extraction Using the Ziemer FEMTO LDV Z8 Platform (CLEAR): One-Year Results

Purpose To present the outcomes and detail the surgical procedure employed in the initial 102 eyes treated with keratorefractive lenticule extraction (KLEx) using the FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems). Methods This was a retrospective analysis of 102 eyes of 53 patients treated with KLEx at the American University of Beirut Medical Center. Visual, refractive, topographic, and aberrometric parameters were evaluated 1 week and 1, 3, 6, and 12 months postoperatively. Results Mean preoperative spherical equivalent refraction (SEQ) was −4.11 ± 1.82 diopters (D) (range: −10.00 to −1.625 D) and mean preoperative cylinder was −0.75 ± 0.65 D (range: −3.00 to 0.00 D). Postoperatively, the mean SEQ was 0.06 ± 0.54 D (range: −2.88 to +1.00 D) at 1 week and −0.04 ± 0.26 D at 12 months and was within ±0.50 D in 95.6% and ±1.00 D in 100% of eyes. A total of 96.7% of eyes had an uncorrected distance visual acuity (UDVA) of 20/20 at 12 months postoperatively. Fifty percent gained one or more lines of corrected distance visual acuity (CDVA), 5 eyes (5.4%) lost one line, and none lost two or more lines. No suction losses were encountered and all extracted lenticules were intact without tears. Conclusions The application of KLEx using the FEMTO LDV Z8 platform yields safe and effective outcomes, aligning comparably with established modes of lenticule extraction and femtosecond laser–assisted laser in situ keratomileusis procedures previously employed and accepted within the field of refractive surgery. [ J Refract Surg . 2024;40(11):e898–e905.]