Refractive Coupling Effects in Keratorefractive Lenticule Extraction Procedures: A Machine Learning–Assisted Approach

Despite the <i>P</i> values less than .05 indicating statistical significance, the observed coupling effects were consistently low, with magnitudes below 10%, even for astigmatism exceeding 2.50 diopters. These couplings may be partly attributed to cross-effects of torsional eye movements. Coupling values for KLEx were markedly lower than those reported for non-aspheric excimer laser ablations. The results suggest that surgical results may be refined further by optimizing nomograms to mitigate coupling effects. <b>[<i>J Refract Surg</i>. 2024;40(10):e706-e715.]</b>.