Visual Performance After Posterior Chamber Phakic Intraocular Lens Implantation and Wavefront-Guided Laser In Situ Keratomileusis for Low to Moderate Myopia

Abstract

To compare postoperative visual function after implantable collamer lens (ICL) implantation and after wavefront-guided laser in situ keratomileusis (LASIK) in eyes with low to moderate myopia. Retrospective observational case study. We investigated 30 eyes of 20 patients undergoing ICL implantation and 64 eyes of 38 patients undergoing wavefront-guided LASIK for the correction of low to moderate myopia (manifest spherical equivalent: -3.00 to -5.88 diopters [D]). Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log contrast sensitivity function was calculated. For 4-mm and 6-mm pupils, the changes in ocular third-order aberrations, fourth-order aberrations, and total HOAs after ICL implantation were significantly less than those after wavefront-guided LASIK (P < .05, Mann-Whitney U test). The postoperative area under the log contrast sensitivity function was significantly increased after ICL implantation (P < .001), whereas, after wavefront-guided LASIK, it was not significantly changed (P = .11). ICL implantation induces significantly fewer ocular HOAs than wavefront-guided LASIK. Moreover, CS was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK in eyes with low to moderate myopia. Thus, even in the correction of low to moderate myopia, ICL implantation appears to be superior in visual performance to wavefront-guided LASIK, suggesting that it may be a viable surgical option for the treatment of such eyes.