Keratorefractive Lenticule Extraction (KLEx) Versus Femtosecond Laser-assisted in Situ Keratomileusis (FS-LASIK) for the Treatment of Myopia and Compound Myopic Astigmatism
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Uncorrected Visual Acuity
研究概览
简要总结
FemtoLASIK is a type of laser eye surgery used to correct vision problems such as nearsightedness, farsightedness, and astigmatism. It involves two main steps: creating a flap and reshaping the cornea. Refractive lenticule extraction, (KLEx) is another laser eye surgery method to correct vision issues, which involves creating and extracting a lenticule without the need of a flap. The investigators will evaluate and compare the efficacy and safety of these two procedures.
详细描述
Keratorefractive lenticule extraction (KLEx) is a refractive surgery technique that does not require the creation of a flap to correct the defects. The potential advantages of this technique are related to the absence of a flap, which could make it the gold standard of refractive surgery. On the other hand, femtosecond-assisted laser in-situ keratomileusis (FS-LASIK) is the most widely practiced refractive surgery worldwide, as it offers excellent visual outcomes but does require the creation of a flap to correct the defects. The objective of this study is to evaluate the effectiveness and safety of KLEx versus FS-LASIK as a treatment option in patients with myopia or compound myopic astigmatism. This is a prospective randomized study. A total of 80 participants will be randomized into two groups, the KLEx group and FS-LASIK group. Following randomization, participants will be followed on the first day after the surgery, 1 week, 1, 3, 6, and 12 months. The primary outcome is the refractive predictability at every postoperative point after surgery, which is the proportion of the number of eyes achieving a postoperative spherical equivalent within ± 0.5 diopters of the intended target. Secondary outcome parameters include quality vision measurements, refraction, visual acuity, and adverse events.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Care Provider, Outcomes Assessor)
盲法说明
Allocation sequence concealment will be done with sealed opaque envelopes. The envelope will be open prior to the intervention only to surgical team. The technique will not be known by the patient or the staff responsible of the follow-up.
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Age 21 years or older
- •Corneal tomography without alterations
- •Myopia between -0.50 and -12.00 D
- •Astigmatism between -0.50 and -6.00 D
排除标准
- •Previous eye surgeries
- •Pregnancy
- •Progressive or unstable myopia and/or compound myopic astigmatism
- •Ocular surface disease
研究组 & 干预措施
FemtoLASIK
For the FS-LASIK technique, the following steps will be followed: application of topical anesthesia to mitigate discomfort and pain throughout the procedure, and the patient will be covered with a sterile drape. Subsequently, the patient will be aligned to artificially flatten the entire corneal surface, ensuring head stability with a slight tilt to optimize surgical access and avoid nasal interference. The femtosecond laser system use will be the ATOS operating system (Schwind eye-tech-solutions, Mainparkstraße 6-10, 63801 Kleinostheim, Germany), which is responsible for creating a corneal incision to create the flap, with controlled precision to ensure proper separation of corneal layers. The excimer laser will be the Amaris (Schwind eye-tech-solutions, Mainparkstraße 6-10, 63801 Kleinostheim, Germany), responsible for performing refractive correction on the cornea through selective photoablation. Following photoablation, the flap will be carefully repositioned, and upon completion
干预措施: FS-LASIK procedure (Procedure)
Keratorefractive lenticule extraction
For the KLEx technique, the following steps will be followed: after topical anesthesia, a sterile drape is placed over the patient, and a speculum is inserted into the eye, centered, and aligned with a curved interface cone before applying suction. The laser used will be the ATOS operating system (Schwind eye-tech-solutions, Mainparkstraße 6-10, 63801 Kleinostheim, Germany), which performs photo-dissection starting from the posterior surface of the refractive lenticule, followed by the creation of the lenticule edge. The anterior surface of the refractive lenticule is formed by extending beyond the posterior diameter of the lenticule by 0.5 mm to form the anterior flap, followed by a peripheral cut. Specific FS laser parameters are employed for each patient. Subsequently, the suction is released, and a Siebel spatula is used to separate and reflect the flap. Finally, the refractive lenticule is extracted using toothless forceps through the small incision. Once the procedure is complet
干预措施: KLEx (Procedure)
结局指标
主要结局
Uncorrected Visual Acuity
时间窗: Day 1, week 1, months 1, 3, 6 & 12th after surgery.
Visual acuity without correction after surgery.
次要结局
- Loss of 2 or more lines of BCVA(Day 1, week 1, months 1, 3, 6 & 12th after surgery.)
- Eyes with 0.5 Diopters within refractive target.(Day 1, week 1, months 1, 3, 6 & 12th after surgery.)
- Postoperative spherical equivalent(Day 1, week 1, months 1, 3, 6 & 12th after surgery.)
- Corrected Distance Visual Acuity(Day 1, week 1, months 1, 3, 6 & 12th after surgery.)
研究者
Nicolas Kahuam Lopez
Consultant
Instituto de Oftalmología Fundación Conde de Valenciana