Subjective and Objective Visual Quality Outcomes After KLEx vs KLEx Xtra: A 2-Year Prospective Randomized Trial

PURPOSE: To compare the 2-year refractive correction outcomes and subjective and objective visual quality between keratorefractive lenticule extraction (KLEx) and KLEx combined with corneal cross-linking (KLEx Xtra). METHODS: . Visual acuity and optical quality (objective and subjective) were assessed preoperatively and at 1, 6, 12, and 24 months postoperatively. RESULTS: < .05), but all metrics became comparable between the groups by 12 to 24 months, Early postoperative increases in HOAs in the KLEx Xtra group resolved by 6 months postoperatively. Subjective quality of vision scores showed no significant intergroup differences at 24 months, except for glare. CONCLUSIONS: KLEx Xtra enhances long-term refractive stability without detriment to visual quality, making it a viable option for patients with borderline risk profiles.