{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:56:28Z","timestamp":1772157388750,"version":"3.50.1"},"reference-count":17,"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>Background This study evaluates the impact of steep preoperative keratometry on postoperative refractive, visual, and higher-order aberration (HOA) outcomes in femtosecond-assisted laser in situ keratomileusis (FS-LASIK) and keratorefractive lenticule extraction (KLEx) procedures for moderate myopia and low astigmatism.<\/jats:p>\n                  <jats:p>Patients and Methods A retrospective analysis of 120 eyes from 120 patients who underwent FS-LASIK or KLEx between 2019 and 2023 was performed. Patients were divided into a steep keratometry group (Kmax 46\u200a\u2013\u200a49 D) and a control group (Kmax 42\u200a\u2013\u200a46 D). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), keratometry values, corneal thickness, and HOAs were assessed preoperatively and at six months postoperatively.<\/jats:p>\n                  <jats:p>Results Postoperative UDVA was lower in the KLEx group compared to FS-LASIK (p\u2009&lt;\u20090.05). SE was more myopic in the KLEx group, probably due to differences in ablation profiles and corneal biomechanics. HOAs increased in all groups, with a significant rise in spherical aberration except in KLEx eyes with steep corneas.<\/jats:p>\n                  <jats:p>Conclusion FS-LASIK and KLEx were effective and safe in eyes with steep preoperative keratometry. However, KLEx resulted in slightly more residual myopia, and postoperative HOAs varied by procedure and preoperative keratometry. Individualized surgical planning is essential, and further prospective studies are needed to assess long-term outcomes.<\/jats:p>","DOI":"10.1055\/a-2740-6465","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:00:46Z","timestamp":1772154046000},"page":"95-102","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Femtosecond-assisted Laser In Situ Keratomileusis (FS-LASIK) and Keratorefractive Lenticule Extraction (KLEx) in Steep Keratometry"],"prefix":"10.1055","volume":"243","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9895","authenticated-orcid":false,"given":"Nilay","family":"Kandemir Besek","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6248-5902","authenticated-orcid":false,"given":"G\u00fclay","family":"Yal\u00e7\u0131nkaya \u00c7ak\u0131r","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-6184","authenticated-orcid":false,"given":"Burcu","family":"Kemer Atik","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5348-9829","authenticated-orcid":false,"given":"Metehan","family":"Simsek","sequence":"additional","affiliation":[{"name":"Ophthalmology, Dogubayazit Dr. Yasar Eryilmaz State Hospital, Agri, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1842-4077","authenticated-orcid":false,"given":"Sibel","family":"Ahmet","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-622X","authenticated-orcid":false,"given":"Seda","family":"Liman Uzun","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7498-3693","authenticated-orcid":false,"given":"Ahmet","family":"Kirgiz","sequence":"additional","affiliation":[{"name":"Ophthalmology, Ministry of Health Istanbul Beyoglu Eye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.jcrs.2013.01.046","article-title":"Laser in situ keratomileusis in United States Naval aviators","volume":"39","author":"D J Tanzer","year":"2013","journal-title":"J Cataract Refract Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0039-6257(97)00119-7","article-title":"Keratoconus","volume":"42","author":"Y S Rabinowitz","year":"1998","journal-title":"Surv Ophthalmol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e0158176","DOI":"10.1371\/journal.pone.0158176","article-title":"Small incision lenticule extraction (SMILE) versus femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia: a systematic review and meta-analysis","volume":"11","author":"Z Shen","year":"2016","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"17854","DOI":"10.1038\/s41598-021-97375-4","article-title":"Impact of extreme (flat and steep) keratometry on the safety and efficacy of small incision lenticule extraction (SMILE)","volume":"11","author":"N Luft","year":"2021","journal-title":"Sci Rep"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/j.jcrs.0000000000001307","article-title":"Photorefractive keratectomy in flat, normal and steep corneas","volume":"50","author":"E Levinger","year":"2024","journal-title":"J Cataract Refract Surg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.opx.0000232227.70122.b5","article-title":"Corneal asphericity and visual function after wavefront-guided LASIK","volume":"83","author":"K M Tuan","year":"2006","journal-title":"Optom Vis Sci"},{"key":"ref7","first-page":"1","article-title":"Small incision lenticule extraction (SMILE) versus laser in-situ keratomileusis (LASIK): study protocol for a randomized, non-inferiority trial","volume":"13","author":"M Ang","year":"2012","journal-title":"Trials"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3928\/1081597X-20140320-03","article-title":"Comparison of the visual results after SMILE and femtosecond laser-assisted LASIK for myopia","volume":"30","author":"F Lin","year":"2014","journal-title":"J Refract Surg"},{"key":"ref9","first-page":"1728","volume-title":"Topographic Analysis in keratorefractive Surgery. Cornea. 4th ed","author":"E Yeu","year":"2017"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.1111\/aos.14078","article-title":"Comparison of efficacy and visual outcomes after SMILE and FS\u2010LASIK for the correction of high myopia with the sum of myopia and astigmatism from \u2212\u200910.00 to \u2212\u200914.00 dioptres","volume":"98","author":"Y Qian","year":"2020","journal-title":"Acta Ophthalmol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/ICO.0000000000000707","article-title":"Clinical outcomes after SMILE and femtosecond laser-assisted LASIK for myopia and myopic astigmatism: a prospective randomized comparative study","volume":"35","author":"M Liu","year":"2016","journal-title":"Cornea"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1055\/a-0914-3152","article-title":"[Comparison of long-term results with small incision refractive Lenticule extraction (ReLEX SMILE) vs. Femto-LASIK]","volume":"236","author":"D R Breyer","year":"2019","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e0618","DOI":"10.1097\/MD.0000000000010618","article-title":"Changes of corneal high-order aberrations after femtosecond laser-assisted in situ keratomileusis","volume":"97","author":"J Wang","year":"2018","journal-title":"Medicine"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1001\/archopht.119.8.1159","article-title":"Effect of larger ablation zone and transition zone on corneal optical aberrations after photorefractive keratectomy","volume":"119","author":"M J Endl","year":"2001","journal-title":"Arch Ophthalmol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3928\/1081-597X-20050701-08","article-title":"Flap-induced and laser-induced ocular aberrations in a two-step LASIK procedure","volume":"21","author":"S Waheed","year":"2005","journal-title":"J Refract Surg"},{"key":"ref16","first-page":"201","article-title":"Wavefront-guided laser in situ keratomileusis (LASIK) versus wavefront-guided photorefractive keratectomy (Prk): a prospective randomized eye-to-eye comparison (an American Ophthalmological Society thesis)","volume":"109","author":"E E Manche","year":"2011","journal-title":"Trans Am Ophthalmol Soc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"e14210","DOI":"10.1097\/MD.0000000000014210","article-title":"Corneal aberrations after small-incision lenticule extraction versus Q value-guided laser-assisted in situ keratomileusis","volume":"98","author":"J Zhang","year":"2019","journal-title":"Medicine"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2740-6465.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T01:00:50Z","timestamp":1772154050000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2740-6465"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":17,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,2,18]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2740-6465","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}