Objective:

To explore long-term visual quality, corneal morphology, and biomechanics in myopic patients undergoing FS-LASIK with and without prophylactic corneal crosslinking (CXL), highlighting the significance of these findings in the context of existing literature.

Key Findings:

• FS-LASIK Xtra showed favorable visual outcomes and corneal stability compared to FS-LASIK alone, with a statistically significant improvement in visual acuity.
• Corneal biomechanics improved significantly in the FS-LASIK Xtra group, as measured by specific biomechanical indices.
• No significant increase in corneal ectasia was observed in patients undergoing FS-LASIK Xtra, supporting its safety profile.

Interpretation:

The addition of prophylactic CXL to FS-LASIK appears to enhance corneal stability and visual outcomes in myopic patients, particularly those at risk of ectasia.

Limitations:

• Retrospective design may introduce selection bias.
• Long-term follow-up beyond two years is needed to assess the durability of outcomes.
• Sample size may limit the generalizability of findings, and demographic diversity should be considered.

Conclusion:

FS-LASIK with prophylactic CXL is a promising approach for myopic correction in at-risk patients, offering improved corneal stability and visual quality, with important implications for clinical practice.