Femtosecond (FS) laser vision correction procedure for moderate to high myopia: a prospective study of ReLEx® flex and comparison with a retrospective study of FS‐laser in situ keratomileusis

Purpose: To present our initial clinical experience with ReLEx^® flex (ReLEx) for moderate to high myopia. We compare efficacy, safety and corneal higher‐order aberrations after ReLEx with femtosecond laser in situ keratomileusis (FS‐LASIK). Methods: Prospective study of ReLEx compared with a retrospective study of FS‐LASIK. ReLEx is a new keratorefractive procedure, where a stromal lenticule is cut by a femtosecond laser and manually extracted. Forty patients were treated with ReLEx on both eyes. A comparable group of 41 FS‐LASIK patients were retrospectively identified. Visual acuity, spherical equivalent (SE) and corneal tomography were measured before and 3 months after surgery. Results: Preoperative SE averaged ?7.50 ± 1.16 D (ReLEx) and ?7.32 ± 1.09 D (FS‐LASIK). For all eyes, mean corrected distance visual acuity remained unchanged in both groups. For eyes with emmetropia as target refraction, 41% of ReLEx and 61% of FS‐LASIK eyes had an uncorrected distance visual acuity of logMAR ≤ 0.10 at day 1 after surgery, increasing to, respectively, 88% and 69% at 3 months. Mean SE was ?0.06 ± 0.35 D 3 months after ReLEx and ?0.53 ± 0.60 D after FS‐LASIK. The proportion of eyes within ±1.00 D after 3 months was 100% (ReLEx) and 85% (FS‐LASIK). For a 6.0‐mm pupil, corneal spherical aberrations increased significantly less in ReLEx than FS‐LASIK eyes. Conclusions: ReLEx is an all‐in‐one femtosecond laser refractive procedure, and in this study, results were comparable to FS‐LASIK. Refractive predictability and corneal aberrations at 3 months seemed better than or equal to FS‐LASIK, whereas visual recovery after ReLEx was slower.