{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:12:17Z","timestamp":1772068337447,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Purpose To evaluate the visual and corneal outcomes of Keratorefractive Lenticule Extraction (KLEx) using a large lenticule diameter with a 7.7\u2009mm optical zone and 7.9\u2009mm cap diameter. The study aimed to determine the feasibility, refractive precision, and potential benefits of larger optical zones in improving visual quality and reducing myopic regression, particularly in patients with larger scotopic pupils.<\/jats:p>\n                  <jats:p>Methods This retrospective case series included 40 eyes from 20 patients who underwent KLEx surgery with the VisuMax800 femtosecond laser. The programmed lenticule diameter was 7.7\u2009mm, and the cap diameter was 7.9\u2009mm, with a cap thickness of 140\u2009\u00b5m and a 2.5\u2009mm incision. Preoperative spherical equivalents ranged from \u2212\u20091.5\u2009D to \u2212\u20094.75\u2009D. Postoperative evaluations were conducted at 3 months, and assessed refractive outcomes, uncorrected visual acuity (UCVA), and residual astigmatism. Surgical planning was based on a personalized nomogram with refractive adjustments for low astigmatic values.<\/jats:p>\n                  <jats:p>Results At 3 months, 100% of eyes achieved a UCVA of 20\/20, and 25% reached 20\/16 or better. The mean postoperative spherical equivalent was +\u20090.14\u2009\u00b1\u20090.27\u2009D. Refractive predictability was high, with 97.5% of eyes within \u00b1\u20090.5\u2009D of intended spherical correction and 90% within \u00b1\u20090.5 D of cylindrical correction. Residual astigmatism was \u2264\u20090.50\u2009D in 87% of cases. No adverse events were reported.<\/jats:p>\n                  <jats:p>Conclusions KLEx using large lenticules is safe, effective, and highly accurate. Larger optical zones may enhance refractive stability and visual quality in patients with large pupils.<\/jats:p>","DOI":"10.1055\/a-2661-4897","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T23:57:31Z","timestamp":1753142251000},"page":"124-130","source":"Crossref","is-referenced-by-count":0,"title":["Expanding Horizons: Visual Outcomes with a 7.7\u2009mm Optical Zone in KLEx Surgery"],"prefix":"10.1055","volume":"243","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1596-3529","authenticated-orcid":false,"given":"David Dietrich","family":"Beckers","sequence":"additional","affiliation":[{"name":"Ophthalmology, Precise Vision Ophthalmologists, Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Kretz","sequence":"additional","affiliation":[{"name":"Ophthalmology, Precise Vision Ophthalmologists, Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian","family":"H\u00f6hn","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Marienhospital Osnabr\u00fcck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Glandorf","sequence":"additional","affiliation":[{"name":"Ophthalmology, Precise Vision Ophthalmologists, Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlev R. H.","family":"Breyer","sequence":"additional","affiliation":[{"name":"Ophthalmology, Breyer, Kaymak, Klabe Eye Surgery, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anke","family":"Messerschmidt-Roth","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Philipps-Universit\u00e4t Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Beckers","sequence":"additional","affiliation":[{"name":"Ophthalmology, Precise Vision Ophthalmologists, Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2467","DOI":"10.2147\/OPTH.S481421","article-title":"Recent Advances in Refractive Surgery: An Overview","volume":"18","author":"B Gurnani","year":"2024","journal-title":"Clin 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