{"id":19521,"date":"2025-03-03T17:21:03","date_gmt":"2025-03-03T16:21:03","guid":{"rendered":"https:\/\/ophtalmo-bw.be\/?page_id=19521"},"modified":"2025-11-19T16:02:37","modified_gmt":"2025-11-19T15:02:37","slug":"klex","status":"publish","type":"page","link":"https:\/\/ophtalmo-bw.be\/en\/klex\/","title":{"rendered":"KLEX"},"content":{"rendered":"

KLEX \u2013 Refractive Surgery by Lenticule Extraction<\/strong><\/h2>\n\n\n\n

This technique is still under development, and we will only offer it to our patients once the manufacturers have made significant progress.<\/em><\/strong><\/p>\n\n\n\n

KLEX (Keratorefractive Lenticule EXtraction)<\/strong> is an advanced laser vision correction technique used to treat myopia (nearsightedness)<\/strong> and astigmatism<\/strong>, without creating a corneal flap.\nIt is part of the same family as SMILE, SILK, CLEAR<\/strong>, and SmartSight<\/strong>.<\/p>\n\n\n

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\ud83d\udd39 Procedure Steps<\/strong><\/h3>\n\n\n\n
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  1. The femtosecond laser<\/strong> creates a small lenticule within the cornea.<\/li>\n\n\n\n
  2. The surgeon manually removes<\/strong> this lenticule, reshaping the cornea to correct the refractive error.<\/li>\n<\/ol>\n\n\n\n
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    \ud83d\udd39 Platforms and Technologies<\/strong><\/h3>\n\n\n\n
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    • Zeiss<\/strong> \u2013 SMILE (Visumax 500 or 800)<\/li>\n\n\n\n
    • Johnson & Johnson<\/strong> \u2013 SILK (Elita laser)<\/li>\n\n\n\n
    • Ziemer<\/strong> \u2013 CLEAR (Z8 laser)<\/li>\n\n\n\n
    • Schwind<\/strong> \u2013 SmartSight (Atos laser)<\/li>\n<\/ul>\n\n\n\n

      All these techniques share the same principle: a lenticule is created and manually extracted<\/strong> to reshape the cornea.<\/p>\n\n\n\n

      \n\n\n\n

      \ud83d\udd39 Technical and Clinical Considerations<\/strong><\/h3>\n\n\n\n

      The KLEX technique does not use an excimer laser<\/strong>, making it less costly than LASIK<\/strong>.\nHowever, the excimer laser offers submicron precision<\/strong> and a smooth, continuous ablation<\/strong>, allowing for more accurate and extensive corrections.<\/p>\n\n\n\n

      The femtosecond laser, by contrast, uses 5\u201310 micron <\/strong> pulses in a dotted pattern, resulting in less refined tissue removal.
      \nDespite being described as \u201cminimally invasive,\u201d KLEX is actually more manual<\/strong> than LASIK: the surgeon must dissect the lenticule with a spatula and remove it through a small side incision.
      \nTo prevent tearing, the lenticule edge must be at least 10 microns thick, leading to removal of ~15 microns of non-optical tissue for handling.<\/p>\n\n\n\n

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      \ud83d\udd39 Advantages and Limitations<\/strong><\/h3>\n\n\n\n

      Theoretical advantages<\/strong> (less corneal cutting, better nerve preservation, reduced dryness) remain unproven<\/strong>.<\/p>\n\n\n\n

      Potential drawbacks include:<\/strong><\/p>\n\n\n\n

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      • manual centration (no automated eye tracker)<\/li>\n\n\n\n
      • meticulous dissection to avoid residual fragments or folds<\/li>\n\n\n\n
      • increased risk of decentration<\/li>\n<\/ul>\n\n\n\n
        \n\n\n\n

        \ud83d\udd39 Postoperative Recovery<\/strong><\/h3>\n\n\n\n

        Temporary blurred vision<\/strong> is common for several weeks or months due to mechanical dissection stress.\nFinal results are comparable to LASIK, but without the typical \u201cWOW effect\u201d<\/strong> (clear vision the next day).<\/p>\n\n\n\n

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        \ud83d\udd39 Biomechanical Aspects<\/strong><\/h3>\n\n\n\n

        Claims of better corneal stability<\/strong> than LASIK or PRK (especially for thin corneas) are theoretical<\/strong> and not confirmed<\/strong> by clinical studies.
        \nA cornea that is unsafe for LASIK is also unsafe for SMILE or KLEX.<\/p>\n\n\n\n

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        \u26a0\ufe0f Complications in SMILE and LASIK<\/strong><\/h2>\n\n\n\n

        Intraoperative (during surgery)<\/strong><\/h3>\n\n\n\n
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        • Loss of suction<\/li>\n\n\n\n
        • Black spots<\/li>\n\n\n\n
        • Abrasions<\/li>\n\n\n\n
        • Epithelial incision tear<\/li>\n<\/ul>\n\n\n\n

          Specific to SMILE \/ KLEX:<\/strong><\/p>\n\n\n\n

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          • Difficult dissection (OBL \u2013 opaque bubble layer<\/em>)<\/li>\n\n\n\n
          • Lenticule tear<\/li>\n\n\n\n
          • Lenticule remnants<\/li>\n\n\n\n
          • Cap perforation<\/li>\n\n\n\n
          • Incomplete lenticule extraction<\/li>\n<\/ul>\n\n\n\n

            Postoperative (after surgery)<\/strong><\/h3>\n\n\n\n
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            • Corneal haze<\/li>\n\n\n\n
            • Irregular astigmatism<\/li>\n\n\n\n
            • Ectasia<\/li>\n\n\n\n
            • Interface infection<\/li>\n\n\n\n
            • Interface inflammation (keratitis<\/em>)<\/li>\n\n\n\n
            • Loss of best-corrected visual acuity (BCVA)<\/li>\n\n\n\n
            • Blurred or \u201cfoggy\u201d vision<\/li>\n\n\n\n
            • \u201cRainbow glare\u201d<\/li>\n\n\n\n
            • Cap displacement or folds (specific to LASIK)<\/li>\n<\/ul>\n\n\n
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              \"\"<\/figure>\n<\/div>\n\n\n
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