Abstract
This study aimed to investigate the effect of myopic defocus on visual acuity after phakic intraocular lens (IOL) implantation and wavefront-guided laser in situ keratomileusis (wfg-LASIK). Our prospective study comprised thirty eyes undergoing posterior chamber phakic IOL implantation and 30 eyes undergoing wfg-LASIK. We randomly measured visual acuity under myopic defocus after cycloplegic and non-cycloplegic correction. We also calculated the modulation transfer function by optical simulation and estimated visual acuity from Campbell & Green’s retinal threshold curve. Visual acuity in the phakic IOL group was significantly better than that in the wfg-LASIK group at myopic defocus levels of 0, –1, and –2 D (p < 0.001, p < 0.001, and p = 0.02, Mann-Whitney U-test), but not at a defocus of –3 D (p = 0.30). Similar results were also obtained in a cycloplegic condition. Decimal visual acuity values at a myopic defocus of 0, −1, −2, and -3 D by optical simulation were estimated to be 1.95, 1.21, 0.97, and 0.75 in the phakic IOL group, and 1.39, 1.11, 0.94, and 0.71 in the wfg-LASIK group, respectively. From clinical and optical viewpoints, phakic IOL implantation was superior to wfg-LASIK in terms of the postoperative visual performance, even in the presence of low to moderate myopic regression.
Highlights
Laser in situ keratomileusis (LASIK) is extensively recognized as a predictable and effective refractive surgical procedure for the correction of myopia and myopic astigmatism
There were no significant differences between the two groups in terms of age (p = 0.27, Mann-Whitney U test), gender (p = 0 .38), preoperative logMAR corrected distance visual acuity (CDVA) (p = 0.53), preoperative cylinder (p = 0.41), postoperative logMAR uncorrected distance visual acuity (UDVA) (p = 0.11), postoperative spherical equivalent (p = 0 .98), or postoperative cylinder (p = 0 .94), there were significant differences in terms of preoperative logMAR UDVA (p < 0 .001), preoperative spherical equivalent (p < 0 .001), and postoperative logMAR CDVA (p = 0.01)
The results of the current study revealed that ICL implantation provided better visual outcomes than wfg-LASIK, even when low to moderate myopic regression occurred after surgery in a clinical setting
Summary
Laser in situ keratomileusis (LASIK) is extensively recognized as a predictable and effective refractive surgical procedure for the correction of myopia and myopic astigmatism. Since LASIK requires more laser ablation in highly myopic eyes, the cornea becomes more oblate, resulting in more surgically induced higher-order aberrations (HOAs), especially spherical aberrations, which may lead to deteriorate intrinsic corneal optical performance[1,2] The Visian Implantable Collamer Lens (ICLTM, STAAR Surgical, Nidau, Switzerland), a posterior chamber phakic intraocular lens (IOL), reportedly offers effective correction of moderate to high ametropia[3,4,5,6,7,8,9,10,11,12,13,14] ICL implantation has been demonstrated to be superior in the great majority of the measures of safety, efficacy, predictability, and stability to conventional or wavefront-guided LASIK (wfg-LASIK) in eyes with all degrees of myopia, from low to high[15,16,17,18]. Optical viewpoints, to prospectively assess the effects of myopic defocus on visual outcomes after ICL implantation and wfg-LASIK for the correction of myopia and myopic astigmatism
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
