Initial CLEAR Nomogram

Sphere-setting calculator · myopia only · Ziemer CLEAR
Planning & teaching tool

Attention. This nomogram is intended only for the CLEAR procedure during initial clinical experience. Settings must be further adjusted and validated against each surgeon's own refractive outcomes. Valid for software version X.5835 or higher · Nomogram v1.0, October 2023.

Manifest refraction

D
D
yr
D
D

Calculated settings

Sphere to enter
Cylinder to enter
Preop MRSE
D
Nomogram input Δ
(MRSE − target)
D
Base sphere adjustment
D
Sim-K adjustment
D
Total sphere adjustment
D
Target refraction (machine)
D

Sphere to enter = manifest sphere + total sphere adjustment. Cylinder is programmed unchanged; set the target refraction field in the CLEAR software separately.

Nomogram reference · active row highlighted

Sphere adjustment
≥ (D)< (D)Adj (D)
−1.50+0.3
−1.50−2.50+0.2
−2.50−3.500.0
−3.50−4.00−0.1
−4.00−5.00−0.3
−5.00−6.50−0.5
−6.50−0.8
Sim-K ≥ 46.0 D → add −0.2 D to the sphere adjustment.
Suggested target refraction
Age (yr)Target (D)
18 – 25+0.50
26 – 30+0.25
31 – 400.00
> 40Surgeon practice

Target for the sphere is always set per the surgeon's own practice and experience.

CLEAR corneal lenticule extraction for advanced refractive correction · myopia only Refractive Planning Suite · Dr. med. Harald C. Gäckle