{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:41:59Z","timestamp":1783032119318,"version":"3.54.6"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The keratorefractive lenticule extraction (KLEx) procedure has gained popularity because of its safety and effectiveness; however, its predictability remains variable, as it may be over- or under-corrected. This study aimed to evaluate visual and refractive outcomes following the utilisation of VISULYZE-generated nomograms (Carl Zeiss Meditec AG, Jena, Germany) and OcuLign cyclotorsion alignment tools (Carl Zeiss Meditec AG, Jena, Germany). Methods: This retrospective consecutive cohort study included patients undergoing KLEx, grouped into four sequential treatment phases: PRE-NOMOGRAM, NOMOGRAM, OCULIGN &amp; NOMOGRAM, and OCULIGN. Results: A total of 688 patients (1264 eyes) were included. The OCULIGN group showed numerically higher efficacy, with 83.0% achieving post-operative (PO) uncorrected distance visual acuity (UDVA) 20\/20 or better, with no loss of corrected distance visual acuity (CDVA) lines, and 67.0% gaining one line. Predictability and accuracy were high across groups, with the OCULIGN group demonstrating a strong correlation between attempted and achieved spherical equivalent (R2 = 0.9908), and 95.5% of eyes within \u00b10.50 D. Early PO outcomes suggested minimal refractive shift at one month. The NOMOGRAM group demonstrated numerically improved astigmatism correction (100.0% within \u22640.50 D), while the OCULIGN &amp; NOMOGRAM group showed high precision in axis alignment. However, baseline imbalances were present, and between-group differences were relatively small. Conclusions: The use of OcuLign cyclotorsion alignment and VISULYZE-generated nomograms was associated with favourable visual and refractive outcomes following KLEx. However, given the retrospective, sequential design, imbalanced baseline, and limited follow-up duration, these findings should be interpreted cautiously. Further prospective, randomised studies with longer follow-up are required to confirm these observations.<\/jats:p>","DOI":"10.3390\/jcm15093389","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:31:56Z","timestamp":1777465916000},"page":"3389","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Utilising VISULYZE-Generated Nomograms and OcuLign Alignment Tools to Improve Keratorefractive Lenticule Extraction Outcomes"],"prefix":"10.3390","volume":"15","author":[{"given":"Sharita Rosalyne","family":"Siregar","sequence":"first","affiliation":[{"name":"JEC Eye Hospitals and Clinics, Jakarta 11520, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5000-3360","authenticated-orcid":false,"given":"Lily Silva","family":"Ardiani","sequence":"additional","affiliation":[{"name":"JEC Eye Hospitals and Clinics, Jakarta 11520, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan Arif","family":"Hutauruk","sequence":"additional","affiliation":[{"name":"JEC Eye Hospitals and Clinics, Jakarta 11520, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/01.APO.0000580144.22353.46","article-title":"Review on Centration, Astigmatic Axis Alignment, Pupil Size and Optical Zone in SMILE","volume":"8","author":"Liu","year":"2019","journal-title":"Asia Pac. 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