Early objective and subjective evaluation of visual quality after KLEx using the VISUMAX 800 platform

To evaluate early visual quality after keratorefractive lenticule extraction (KLEx) using VISUMAX 800 femtosecond laser for myopia correction. The prospective cohort study included 193 eyes of 97 consecutive myopic patients (mean SE -4.48 ± 1.66 D) who underwent KLEx using the VISUMAX 800 platform at Fudan University Eye and ENT Hospital. Standardized preoperative and postoperative evaluations included slit-lamp examination, visual acuity, manifest refraction, corneal topography, wavefront aberration, and subjective visual quality questionnaires. All patients completed the 3-month follow-up protocol. All procedures were successfully completed with high patient satisfaction. The efficacy and safety indices were 1.07 ± 0.11 and 1.10 ± 0.11, respectively. No eye lost two or more lines of CDVA. Among eyes targeted for plano correction, 99% (184/185) achieved UDVA ≥ 1.0. All eyes achieved SE within ±0.50 D of target. Total higher-order aberration, coma, and trefoil increased significantly (all P < 0.05), while spherical aberration showed no significant changes ( P > 0.05). Postoperative glare and halo symptoms became less frequent, severe, and bothersome over time, yet glare scores remained above baseline levels. Multivariate analysis identified coma ( OR = 1.68, P = 0.02) and scotopic pupil diameter ( OR = 1.92, P = 0.01) as independent factors for postoperative glare and halos, respectively. KLEx using the VISUMAX 800 platform demonstrated excellent safety, efficacy, and predictability for myopia correction, with high patient satisfaction. Early postoperative glare and halo symptoms gradually diminished.