Original article
Visual Performance after Implantable Collamer Lens Implantation and Wavefront-Guided Laser In Situ Keratomileusis for High Myopia

https://doi.org/10.1016/j.ajo.2009.02.001Get rights and content

Purpose

To compare postoperative visual function after implantable collamer lens (ICL; STAAR Surgical, Nidau, Switzerland) implantation and after wavefront-guided laser in situ keratomileusis (WFG-LASIK) in eyes with high myopia.

Design

Retrospective, observational case study.

Methods

We investigated 46 eyes of 33 patients undergoing ICL implantation and 47 eyes of 29 patients undergoing WFG-LASIK (Technolas217z; Bausch & Lomb, Rochester, New York, USA) for the correction of high myopia (manifest spherical equivalent ≤ −6 diopters). Ocular higher-order aberrations (HOA) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry (KR-9000; Topcon, Tokyo, Japan) and a CS unit (VCTS-6500; Vistech Consultants Inc, Dayton, Ohio, USA) before and 3 months after surgery, respectively. From the CS, the area under the log CS function (AULCSF) was calculated.

Results

For a 4-mm pupil, the changes in ocular coma-like aberrations, spherical-like aberrations, and total HOAs after ICL implantation were significantly less than those after WFG-LASIK (P < .001, Mann–Whitney U test). The postoperative AULCSF was significantly increased after ICL implantation (P < .001), whereas after WFG-LASIK, it was significantly decreased (P < .001).

Conclusions

ICL implantation induces significantly fewer ocular HOAs than WFG-LASIK. Moreover, CS was improved significantly after ICL implantation, but deteriorated after WFG-LASIK in eyes with high myopia. Thus, in the correction of high myopia, ICL implantation seems to be superior in visual performance to WFG-LASIK, suggesting that it may be a better surgical option for the treatment of such eyes.

Section snippets

Patient Population

Forty-six eyes (21 men and 25 women) of 33 patients who underwent implantation of the PCP ICL, and 47 eyes (25 men and 22 women) of 29 patients who underwent WFG-LASIK for the correction of high myopia (manifest spherical equivalent, ≤ −6 diopters [D]), were included in this observational study. The mean patient ages ± standard deviation at the time of surgery were 35.0 ± 10.3 years (range, 18 to 59 years) in the ICL group and 36.3 ± 8.7 years (range, 21 to 56 years) in the WFG-LASIK group. The

Patient Population

Preoperative patient demographics are summarized in the Table 1. There were no significant differences between the 2 groups in terms of age (P = .40, Mann–Whitney U test), gender (P = .47), logMAR BSCVA (P = .12), HOAs (P = .06 for coma-like aberrations, P = .45 for spherical-like aberrations, and P = .13 for total HOAs for a 4-mm pupil; P = .59 for coma-like aberrations, P = .99 for spherical-like aberrations, and P = .91 for total HOAs for a 6-mm pupil), or AULCSF (P = .14). However, the

Discussion

In the current study, we demonstrated that ICL implantation induced significantly fewer ocular HOAs than did WFG-LASIK in the treatment of high myopia. Moreover, we also demonstrated that ICL implantation increases CS significantly, but that WFG-LASIK significantly decreases it. Sanders and Vukich reported that the ICL had advantages over LASIK in eyes with moderate to high myopia as well as those with low myopia.12, 13 Recently, Sanders also demonstrated that ICL was superior to LASIK for

Akihito Igarashi, MD, graduated from Kitasato University, Faculty of Medicine, and specialized in ophthalmology in Sanno Hospital, Japan. Dr Igarashi is a researcher of Corneal Research and Refractive Surgery in Kitasato University Hospital, Japan.

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    Akihito Igarashi, MD, graduated from Kitasato University, Faculty of Medicine, and specialized in ophthalmology in Sanno Hospital, Japan. Dr Igarashi is a researcher of Corneal Research and Refractive Surgery in Kitasato University Hospital, Japan.

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