Implantable Collamer Lens Group Research Articles

Visual outcomes with implantable Collamer lens versus small incision lenticule extraction in moderate-high myopia: A pilot study.

To compare the visual outcomes of implantable Collamer lens (ICL) with small incision lenticule extraction (SMILE) in cases of moderate-high myopia. A prospective comparative study was conducted on 60 eyes of 30 patients with moderate-high myopia (-3D to -8D with astigmatism ≤1 D) at a tertiary eye care center. Patients underwent either SMILE or ICL in both eyes and had a postoperative follow-up of 1 year. The manifest refractive spherical equivalent was -5.22 ± 1.05 D and -5.4 ± 1.17 D in the SMILE and ICL groups, respectively (P = 0.53). The mean sphere and cylinder were comparable between the groups. The mean uncorrected visual acuity improved from 1.18 ± 0.19 logMAR to 0.03 ± 0.07 logMAR in SMILE and 1.14 ± 0.25 logMAR to 0.011 ± 0.04 logMAR in the ICL group. The efficacy for SMILE was 83.3% and that for ICL was 93.3%. Safety and predictability (±0.5D) for both was 100%. A significant increase was observed in ocular aberration with a decrease in modular transfer function in the eyes that underwent SMILE, whereas no significant change in the eyes that underwent ICL. A significant difference was observed in all parameters of ocular aberration except corneal trefoil, corneal astigmatism, and PSF between the two groups at the final follow-up. The contrast sensitivity at final follow-up was higher in ICL cases when compared to SMILE. The quality of vision (QoV) score suggested a better QoV with ICL; however, the difference was not statistically significant. Both SMILE and ICL are safe in patients with moderate-high myopia. The efficacy, contrast sensitivity, and postoperative ocular aberration profile are better in cases undergoing ICL.

Comparison of formulas in the implantable collamer lens vault prediction.

To compare the predictability of different formulas in the postoperative vault of an implantable collamer lens (ICL) surgery and assist physicians for formula selection in ICL implantation. This is a retrospective study. Patients who underwent ICL implantation between August 31, 2021 and October 29, 2021 at our clinic were reviewed. The clinical data, predicted ICL sizes and vaults, actual ICL size implanted and vaults at 1 month after surgery, and corresponding prediction formulas used were collected and analyzed. This study included 140 eyes from 72 patients (15 males and 57 females). Differences between ICL sizes recommended by the Visian ICL Online Calculation & Ordering System (OCOS) and NK formula (Version. 3) or KS formula (Version. 4) were statistically significant (P < .0001), except for the recommended ICL sizes between the NK and KS formulas (P > .05). Better consistency between predicted ICL vaults and achieved ICL vaults was observed when using the KS formula compared to the NK formula. The actual ICL vaults were 250 to 750 μm at 1 month after surgery in 66.4%, 76.5%, and 80.5% eyes of the OCOS, NK, and KS groups, respectively. There was significant difference between the OCOS and KS groups (P < .05), especially in the 12.6 mm ICL group. The KS formula is the most accurate formula for recommending an ICL size and vault prediction when compared to the NK formula and OCOS. Further studies for a more accurate formula are warranted.

Postoperative efficacy, safety, predictability, and visual quality of implantable collamer lens implantation versus small incision lenticule extraction in myopic eyes: a Meta-analysis.

To compare the postoperative efficacy, safety, predictability, and visual quality of implantable collamer lens (ICL) implantation versus small incision lenticule extraction (SMILE) in myopia eyes. PubMed, EMBASE, Web of Science, Cochrane Library and several Chinese databases were searched at May 2021 to select relevant studies in comparison of clinical outcomes between ICL implantation and SMILE for myopia. The primary outcomes were efficacy, safety, and predictability. And the secondary outcomes were postoperative higher-order ocular aberrations (HOAs), modulation transfer function cutoff frequency (MTF), objective scatter index (OSI), contrast sensitivity and a quality of vision (QoV) questionnaire. A total of 1036 eyes from 10 studies, of which 503 eyes underwent ICL implantation and 533 eyes underwent SMILE, were enrolled in this Meta-analysis. Pooled results revealed that ICL group had a better safety index and post-corrected distance visual acuity (CDVA) (P=0.007, <0.00001, respectively), and a lower percentage of eyes with a postoperative CDVA lost 1 line (P=0.007) than the SMILE group. No significant differences were found in comparison of the other primary outcomes. In the long-term follow-up (>6mo), ICL group had a lower total HOA, coma, and spherical aberration than SMILE group (P=0.003, <0.00001, 0.04). Yet higher trefoil was found in ICL group at 6mo after surgery (P=0.003). Additionally, ICL group also had a higher MTF value (P=0.02), and a higher contrast sensitivity score for spatial frequencies of 1.5, 6, and 12 cpds (P=0.02, 0.005, 0.02, respectively). And it also had a lower score of bothersome in QoV questionnaire than SMILE group (P=0.003). ICL implantation and SMILE have similar and comparable outcomes in term of the efficacy and predictability for correcting high myopia. However, ICL group is relatively safer and also has better visual quality in comparison of SMILE group.

A meta-analysis of visual outcomes and optical quality after small incision lenticule extraction versus implantable collamer lens for myopia.

To evaluate possible differences in visual outcome and optical quality when small incision lenticule extraction (SMILE) versus implantable collamer lens (ICL) is used to correct myopia. PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched up to August 2021 to identify relevant studies. The PRISMA guidelines were followed. Primary outcomes were postoperative efficacy, safety, and predictability at the end of follow-up. Secondary outcomes were changes in modulation transfer function cutoff frequency (MTF cut-off), objective scatter index (OSI) values, total higher-order aberrations (HOAs), spherical aberrations, and coma aberrations. Seven studies with a total of 1296 eyes (SMILE: 731 eyes; TECXL: 565 eyes) were included. The ICL group had a better MTF cut-off (P = 0.007) and less change in the proportion of HOAs (P < 0.001), spherical aberrations (P = 0.009), and coma (P = 0.006) than the SMILE group. For the other outcomes, there were no statistically significant differences. SMILE and ICL implantation are comparable in efficacy, safety, and predictability for correcting myopia. Larger studies with longer follow-up times are warranted to provide a better understanding of the benefits of SMILE and ICL implantation.

A Comprehensive Investigation of Contrast Sensitivity and Disk Halo in High Myopia Treated With SMILE and EVO Implantable Collamer Lens Implantation.

PurposeTo investigate the clinical outcomes in small incision lenticule extraction (SMILE) and EVO implantable Collamer lens (ICL)–treated high myopia.MethodsThirty-three SMILE-treated and 32 EVO ICL-treated patients were included and followed up for 6 months. Subjective refraction, contrast sensitivity, and disk halo size were measured preoperatively and postoperatively. Patient-reported outcomes (PROs) were obtained at the final visit.ResultsSignificant differences in efficacy and safety indices were observed between the SMILE and EVO ICL groups at 6 months postoperatively (P < 0.05). In the SMILE group, the mesopic contrast sensitivity at 2.2 cycles per degree (cpd) and photopic contrast sensitivity at 0.5, 3.4, and 7.1 cpd were significantly improved. In the EVO ICL group, the mesopic contrast sensitivity at 7.1 cpd and photopic contrast sensitivity at 0.5, 7.1, and 14.6 cpd were significantly improved. The halo radii after SMILE were significantly increased at 1 week, showed a decreasing trend at 1 month, returned to baseline at 3 months, and progressed stably at 6 months. However, it was unchanged in the EVO ICL group. Regarding subjective experience, haloes were the most common disturbance with mild and little bothersomeness after EVO ICL in contrast to starbursts after SMILE.ConclusionsEVO ICL implantation yielded better visual outcomes, improved contrast sensitivity particularly at high spatial frequencies, had a stabler disk halo size, and increased incidence of haloes, with less influence than that of SMILE.Translational RelevanceThe disk halo and PRO findings will be of benefit for consultations and evaluations in visual performance and disturbances.

Comparison of accommodation and accommodative micro-fluctuation after implantable collamer lens and LASIK surgery for myopia

BackgroundTo longitudinally analyze and compare the accommodative micro-fluctuation (MFs) and accommodative function between myopic patients after implantable collamer lens (ICL) implantation and laser in situ keratomileusis (LASIK).MethodsPatients with good corrected visual acuity (20/20 or better) and underwent ICL (V4c) and LASIK for myopic-correction (ranging from − 3.50 to − 8.50 D) were recruited. Refraction, amplitude of accommodation (AMP), accommodative lag, higher-order aberration (HOA), and MFs were recorded before surgery and 1 and 3 months after surgery. The ACOMEREF automatic refractor was used to measure the high-frequency component (HFC) of the MFs, which suggested tension of the ciliary muscle.ResultsThe study comprised 120 eyes. At 3 months after surgery, the manifest refractive spherical equivalent of the ICL and LASIK groups were − 0.11 and − 0.09 D, respectively (p = 0.46). HFC values were significantly higher at 1 month (p = 0.03) and 3 months postoperatively (p = 0.03) in the ICL group compared to that in the LASIK group. The ocular HOA of the ICL group was 1.08 ± 0.43 μm, which was lower than the LASIK group 1.45 ± 0.54 μm (p = 0.01). No significant differences in AMP and accommodative lag between groups were noted at 3 months postoperatively. There was a positive correlation between HFC and vault of the ICL lens (r2 = 0.14, p = 0.005). There were no correlations between HFC and ocular HOA and postoperative MRSE in the two groups (all p>0.05).ConclusionsThe HFC increased significantly after an early period of ICL implantation compared to laser in situ keratomileusis for myopic correction, which indicated increased tension of the ciliary muscle, and had a positive correlation on the vault of the ICL lens; However, studies with longer follow-up time and more structural evaluation are needed.

Visual outcome after Femtolasik vs. ICL for correction of high myopia

ObjectivesTo compare visual outcomes between femtosecond Lasik and implantable collamer lens (ICL) in patients with high myopia.BackgroundEven though the parameters for optical quality as well as intraocular scattering are valuable for the subsequent satisfaction and postoperative visual performance in myopia, the comparison between patients with Femtolasik (FS-Lasik) and ICL implantation of these parameters is still unclear.Materials and methodsThis study involved 50 high myopic eyes ≥−6.0 D recruited for FS-Lasik (group 1) and another 50 high myopic eyes recruited for ICL (group 2). Both age and sex were matched in the two groups.ResultsVisual acuities (VA) showed significant improvement in FS-Lasik group than ICL group 1 day postoperatively, whereas after 1 week, they had no difference (P > 0.05), but in the third and sixth months postoperatively, there was a statistically significant increase in VA in ICL group than FS-Lasik group. It was observed that there is a stability of VA after FS-Lasik and ICL groups, which indicated that eyes with FS-Lasik group tend to regress by time, whereas in ICL group, the line tends to be more stable. However, both groups showed highly significant improvement in VA (P < 0.001).ConclusionICL implantation is a better first choice especially in young adults who had high myopia and need the near vision. ICL seems to be better than FS-Lasik in the long-lasting correction of vision, and also, it has a better durability.

Clinical results of Visian implantable collamer lens implantation according to various sizes and implantation angles.

To investigate the clinical outcomes of Visian implantable collamer lens (ICL) implantation according to lens size and implantation angle. Onnuri Smile Eye Clinic, Seoul, Republic of Korea. Retrospective case series. This study included 566 eyes of 283 patients treated with ICL implantation. Patients were divided into three groups: horizontally implanted same-sized ICL (group A), horizontally implanted different sized-ICL (group B: large ICL and small ICL) and same sized-ICL implanted with a different implantation angle (group C: horizontal and vertical). At 12-month follow-up, the mean vault was 0.78 ± 17, 0.48 ± 0.13, 0.71 ± 0.18 and 0.44 ± 0.16 mm when large and small sized ICL was used in group B (p < 0.001), and when ICL was horizontally and vertically implanted in group C (p = 0.021), respectively. And the mean SE was -0.11 ± 0.30, -0.34 ± 0.42, -0.3 ± 0.56 and -0.64 ± 0.66 dioptres (D), when the large and the small sized ICL was used group B (p = 0.039), and when the ICL was horizontally and vertically implanted in group C (p = 0.036), respectively. No significant difference in UDVA, IOP and ECD between both eyes in groups B and C was observed. No statistical difference was found in the vault between both eyes for groups B and C. The vault was significantly higher and the SE was significantly more hyperopic when a larger-sized ICL was used or the ICL was horizontally implanted compared to when the ICL was vertically implanted.

Optical and visual quality comparison of implantable collamer lens and femtosecond laser assisted laser in situ keratomileusis for high myopia correction.

To compare clinical outcomes and refractive stability of implantable collamer lens (ICL) implantation and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia correction. The Optical Quality Analysis System (OQAS) was used to evaluate clinical outcomes objectively after operation for high myopia correction. We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety index, efficacy index, spherical equivalent, modulation transfer function (MTF) cutoff frequency, strehl ratio (SR) and objective scatter index (OSI). At 1y postoperatively, the safety indices were 1.33±0.27 in ICL group, and 1.17±0.24 in FS-LASIK group. 39.58% in the ICL group and 27.59% in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA. The efficacy indices were 1.28±0.22 in ICL group, and 1.13±0.26 in FS-LASIK group. The changes of spherical equivalent from 1wk to 1y postoperatively was -0.12±0.37 D in ICL group, and -0.79±0.58 D in FS-LASIK group (P<0.05). Spherical equivalent within ±0.50 D was achieved in 97.92% in ICL group and 68.97% in FS-LASIK group. MTF cutoff frequency were higher with ICL as compared to FS-LASIK (P<0.05) at each postoperative follow-up stage; for postoperative 1mo later, SR was statistically significant difference between two groups (P<0.05); with no statistically significant difference in OSI between two groups (P>0.05) in postoperative 3mo later. ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction. ICL implantation provides better clinical outcomes and refractive stability than FS-LASIK.

Preliminary Clinical Study of a LenSx Femtosecond Laser-Assisted Limbal Relaxing Incision for the Correction of High Myopia with Low to Moderate Astigmatism in Posterior Implantable Collamer Lens Implantation

Purpose. To evaluate the safety, efficacy, and predictability of implantable collamer lens (ICL) implantation combined with a LenSx femtosecond laser-assisted limbal relaxing incision (LRI) for the correction of corneal astigmatism. Methods. This prospective study enrolled 64 eyes (54 patients) with high myopia with low to moderate regular corneal astigmatism. They were divided into an ICL group with ICL implantation (18 patients, 20 eyes), a TICL group with toric ICL implantation (17 patients, 23 eyes), and a LenSx + ICL group with a LenSx femtosecond laser-assisted LRI and an ICL implantation (19 patients, 21 eyes). Visual acuity, astigmatism correction ability, and visual quality were measured before and 1, 3, and 6 months after surgery. Results. The postoperative visual acuity of the 3 groups was higher than the preoperative visual acuity ( P &lt; 0.01 ), and the improvements in the LenSx + ICL group and the TICL group were greater than those in the ICL group ( P &lt; 0.01 ). The LenSx + ICL and TICL groups had less residual astigmatism and a higher astigmatism correction index (CI) than the ICL group ( P &lt; 0.01 ). There was no significant difference among the three groups in total high-order aberrations (HOAs) before and after surgery ( P &gt; 0.05 ). Conclusion. LenSx femtosecond laser-assisted LRI can effectively correct low to moderate corneal astigmatism during ICL implantation surgery. It can achieve similar clinical effects in the short term compared with TICL implantation.

Static and dynamic pupillary characteristics in high myopic eyes with two implantable collamer lenses

To determine static and dynamic pupillometry characteristics before and after implantable collamer lens (ICL) (V4 and V4c) implantation. Shanghai, China. Prospective consecutive observational case series. Patients who had either V4 or V4c ICL implantation were included in this observational study. An automatic quantitative pupillometry system (MonCv3) was used for pupillometry preoperatively and 1week, 1month, and 3months after surgery. Static pupillometry measurements (pupil diameters [PDs] at 4 standardized illumination levels) and dynamic parameters (including initial PD, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, and velocity of dilation) were measured. The study comprised 98 eyes (50 patients). Mesopic and low photopic PDs declined by 0.32mm and 0.27mm, respectively, at 3months after ICL implantation; scotopic PD declined at 1week and recovered to preoperative levels at 3months; and high photopic PD remained unchanged. Regarding the pupil light reflex, contraction amplitude and velocity declined after surgery, whereas other dynamic parameters remained unchanged. The static and dynamic pupillary characteristics were similar between the V4 and V4c ICL groups. The V4 and V4c ICLs had similar influences on iris motility. ICL implantation had a miotic effect under mesopic and low photopic illumination conditions, resulting in decreases in pupil contraction amplitude and velocity in light reflexes.

Comparison of optical quality after implantable collamer lens implantation and wavefront-guided laser in situ keratomileusis.

To compare the optical quality after implantation of implantable collamer lens (ICL) and wavefront-guided laser in situ keratomileusis (WG-LASIK). The study included 40 eyes of 22 patients with myopia who accepted ICL implantation and 40 eyes of 20 patients with myopia who received WG-LASIK. Before surgery and three months after surgery, the objective scattering index (OSI), the values of modulation transfer function (MTF) cutoff frequency, Strehl ratio, and the Optical Quality Analysis System (OQAS) values (OVs) were accessed. The higher order aberrations (HOAs) data including coma, trefoil, spherical, 2nd astigmatism and tetrafoil were also obtained. For patients with pupil size <6 mm, HOAs data were analyzed for 4 mm-pupil diameter. For patients with pupil size ≥6 mm, HOAs data were calculated for 6 mm-pupil diameter. Visual acuity, refraction, pupil size and intraocular pressures were also recorded. In both ICL and WG-LASIK group, significant improvements in visual acuities were found postoperatively, with a significant reduction in spherical equivalent (P< 0.001). After the ICL implantation, the OSI decreased slightly from 2.34±1.92 to 2.24±1.18 with no statistical significance (P=0.62). While in WG-LASIK group, the OSI significantly increased from 0.68±0.43 preoperatively to 0.91±0.53 postoperatively (Wilcoxon signed ranks test, P=0.000). None of the mean MTF cutoff frequency, Strehl ratio, OVs showed statistically significant changes in both ICL and WG-LASIK groups. In the ICL group, there were no statistical differences in the total HOAs for either 4 mm-pupil or 6 mm-pupil. In the WG-LASIK group, the HOA parameters increased significantly at 4 mm-pupil. The total ocular HOAs, coma, spherical and 2nd astigmatism were 0.12±0.06, 0.06±0.03, 0.00±0.03, 0.02±0.01, respectively. After the operation, these values were increased into 0.16±0.07, 0.08±0.05, -0.04±0.04, 0.03±0.01 respectively (Wilcoxon signed ranks test, all P<0.05). At 6 mm-pupil, the induction of total HOAs was not statistically significant in the WG-LASIK group. ICL implantation has a less disturbance to optical quality than WG-LASIK. The OQAS is a valuable complementary measurement to the wavefront aberrometers in evaluating the optical quality.

Comparison on visual quality after ICL implantation and femtosecond laser LASIK in correction of high myopia

Objective To compare the visual quality after implantable collamer lens (ICL) implantation and femtosecond laser in situ keratomileusis(FS-LASIK) in correction of high myopia. Methods The data of 182 eyes of 91 cases who underwent refractive surgery were collected and retrospectively analyzed. The patients were divided into two groups: ICL group, 78 eyes of 39 cases, underwent ICL implantation; LASIK group, 104 eyes of 52 cases, underwent FS-LASIK. The postoperative visual quality between the two groups were compared. Results The difference of safety index at 1, 3 and 6 months postoperatively between the two groups were not statistically significant( P=1.000, 0.373, 0.230). The difference in validity index at 3 and 6 months postoperatively between the two groups were statistically significant (P=0.000, 0.000). The difference in diopter at 3 and 6 months postoperatively between the two groups were statistically significant (P=0.042, 0.002). The increasing amplitude of total high order aberration, spherical aberration and coma aberration at 6 months postoperatively in ICL group were lower than those in LASIK group(P=0.000, 0.000, 0.001). Six months after surgery, the difference of contrast sensitivity were not significant between two groups at 1.5 cpd, 3.0 cpd and 6.0 cpd spatial frequencies under light condition(P=0.576, 0.659, 0.840), however, the difference of contrast sensitivity in ICL group were higher than that in LASIK group at 12.0 cpd and 18.0 cpd (P=0.000, 0.000). Under mesopic condition, the contrast sensitivity in ICL group were higher statistically at all spatial frequencies than in LASIK group(P=0.000, 0.000, 0.000, 0.000, 0.000). Conclusion The postoperative long-term uncorrected visual acuity and diopter are more stable in patients with ICL implantation, and the higher order aberration increase less, and the contrast sensitivity is improved in each spatial frequency. The postoperative visual quality is significantly better than FS-LASIK. ICL implantation is a surgical approach of strong predictive, high safety and good stability to treat high myopia. Key words: Lens, intraocular, phakic, posterior chamber; Collamer lens, implantable; Laser in situ keratomileusis, femtosecond; Myopia, high; Visual quality

A comparative study of visual quality between implantable collamer lens implantation and femtosecond LASIK for myopia

Background The incidence of myopia is gradually increasing, and how to choose a better corrective method of myopia for the best visual demand is very important. Objective This study was to compare visual quality of implantable collamer lens (ICL) implantation with femtosecond laser in situ keratomileusis (FS-LASIK) for moderate and high myopia using double-pass optical quality analysis system (OQAS). Methods A non-randomized controlled clinical trail was performed.Fifty-two eyes with -4.00 to -9.00 D of 26 consecutive patients were included in NO.1 Hospital of Xi'an from January 2015 to January 2016.Twenty-four eyes of 12 patients with the corneal thickness 0.05). All the patients were followed-up for 3 months after surgery.The preoperative best corrected distance visual acuity (BCDVA), spherical equivalent (SE), postoperative uncorrected distance visual acuity (UCDVA), BCDVA and SE were examined and compared between two groups.The parameters from OQAS were evaluated and intergrouply compared, including the objective scattering inders (OSI), modulation transfer function (MTF) cut off frequency, Strehl ratio and OQAS values under the contrast of 100%, 20% and 9%(OV100, OV20, OV9). Results The postoperative BCDVA was not significantly different from preoperative UCDVA in both ICL group and FS-LASIK group (-0.04±0.10 vs. 0.05±0.12; -0.07±0.12 vs.0.00±0.12) (t=3.128, 2.358, both at P>0.05). No statistically significant differnces were found in SE, UCDVA and BCDVA after operation between ICL group and FS-LASIK group (t=1.292, 0.900, -0.653, all at P>0.05). OQAS examination showed that MTF cut off, OSI, Strehl ratio, OV100 were not significantly different after operation between ICL group and FS-LASIK group (t=-2.032, -1.440, -0.224, all at P>0.05). The postoperative OV20 and OV9 were 0.82±0.14 and 0.80±0.21 in the ICL group, which were significantly higher than those in the FS-LASIK group(0.59±0.15 and 0.47±0.13)(t=4.105, 4.702, both at P<0.05). Conclusions Both ICL implantation and FS-LASIK provide good optical and visual quality for moderate to high myopic eyes, and ICL appears to have a better visual quality in comparison with FS-LASIK under the contrasts of 20% and 9%. Key words: Myopia/surgery; Refractive surgical procedure; Phakic intraocular lenses; Keratomileusis, laser in situ; Visual quality; Implantable collamer lens; Double-pass optical quality analysis system

A prospective comparison of phakic collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia.

PurposeThe aim of this study was to evaluate and compare night vision and low-luminance contrast sensitivity (CS) in patients undergoing implantation of phakic collamer lenses or wavefront-optimized laser-assisted in situ keratomileusis (LASIK).Patients and methodsThis is a nonrandomized, prospective study, in which 48 military personnel were recruited. Rabin Super Vision Test was used to compare the visual acuity and CS of Visian implantable collamer lens (ICL) and LASIK groups under normal and low light conditions, using a filter for simulated vision through night vision goggles.ResultsPreoperative mean spherical equivalent was −6.10 D in the ICL group and −6.04 D in the LASIK group (P=0.863). Three months postoperatively, super vision acuity (SVa), super vision acuity with (low-luminance) goggles (SVaG), super vision contrast (SVc), and super vision contrast with (low luminance) goggles (SVcG) significantly improved in the ICL and LASIK groups (P<0.001). Mean improvement in SVaG at 3 months postoperatively was statistically significantly greater in the ICL group than in the LASIK group (mean change [logarithm of the minimum angle of resolution, LogMAR]: ICL =−0.134, LASIK =−0.085; P=0.032). Mean improvements in SVc and SVcG were also statistically significantly greater in the ICL group than in the LASIK group (SVc mean change [logarithm of the CS, LogCS]: ICL =0.356, LASIK =0.209; P=0.018 and SVcG mean change [LogCS]: ICL =0.390, LASIK =0.259; P=0.024). Mean improvement in SVa at 3 months was comparable in both groups (P=0.154).ConclusionSimulated night vision improved with both ICL implantation and wavefront-optimized LASIK, but improvements were significantly greater with ICLs. These differences may be important in a military setting and may also affect satisfaction with civilian vision correction.

Comparison of the Visian ICL and Verisyse Phakic Intraocular Lenses for Myopia From 6.00 to 20.00 Diopters

To compare visual and refractive outcomes between the Visian Implantable Collamer Lens (ICL) and Verisyse phakic intraocular lens. Comparative interventional case series for myopia between 6.00 and 20.00 diopters (D). Thirty consecutive eyes of 16 patients had a Visian ICL implanted and 31 consecutive eyes of 19 patients had the Verisyse lens implanted. Outcomes measured at 3 months postoperatively included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and refractive predictability as well as adverse events. Preoperatively, the groups were no different in regard to age (P=.72) and spherical equivalent refraction (P=.38). Postoperative UCVA of 20/20 or better and 20/25 or better in the Visian ICL group was 67% and 96%, respectively, compared to 63% and 79%, respectively, in the Verisyse lens group (P=.10). Binocular UCVA of 20/20 or better and 20/25 or better in the Visian ICL group was 92% and 100%, respectively, and in the Verisyse group, 70% and 80%, respectively (P=.007). One and two lines gain of postoperative BSCVA in the Visian ICL group was 40% and 10%, respectively, which was statistically significantly better than the Verisyse group of 16% and 6%, respectively (P=.025). Postoperative deviation from target refraction was 0.038+/-0.39 D in the Visian ICL group and -0.38+/-0.89 D in the Verisyse lens group (P=.018). Monocular UCVA was similar for both groups, whereas binocular UCVA was better in the Visian ICL group. The Visian ICL group had more accurate refractive outcomes than the Verisyse lens group.

Matched Population Comparison of the Visian Implantable Collamer Lens and Standard LASIK for Myopia of -3.00 to -7.88 Diopters

To compare matched populations of LASIK and Visian Implantable Collamer Lens (ICL) cases in the correction of myopia between -3.00 and -7.88 diopters (D). One hundred sixty-four LASIK eyes with prospective data collected from a single center and 164 ICL eyes from the multicenter US ICL Clinical Trial were compared in this observational non-randomized study. The LASIK and ICL groups were well matched for age, gender, and mean level of preoperative spherical equivalent refraction. At 6 months, best spectacle-corrected visual acuity (BSCVA) > or = 20/20 was 85% with LASIK and 95% with ICL (P = .003) compared to preoperative values of 93% and 88%, respectively (P = .292). Loss of > or = 2 lines of BSCVA was significantly lower with the ICL at 1 week (0.6% vs 10%, P < .001) and 1 month (7% vs 0%, P = .001) with comparable outcomes at 6 months (0% vs 1%). At 6 months postoperatively, uncorrected visual acuity (UCVA) > or = 20/15 (11% vs 25%, P = .001) and > or = 20/20 (49% vs 63%, P = .001) was better in the ICL cases. Predictability within 0.50 D at 6 months for ICL cases was 85% (67% LASIK, P < .001); 97% of ICL cases were within 1.00 D (88% LASIK, P = .002). Refractive stability (+/- 0.50 D) between 1 and 6 months was 93% with ICL compared to only 82% with LASIK (P = .006). The ICL performed better than LASIK in almost all measures of safety, efficacy, predictability, and stability in this matched population comparison, supporting the ICL as an effective alternative to existing refractive laser surgical treatments for the range of myopia studied.