ICLs correct high myopia better than all-laser LASIK

Implantable contact lenses appear to correct high myopia more accurately than customized all-laser LASIK, and the phakic lenses also provide a better quality of vision, according to results of a retrospective study of 79 consecutive eyes undergoing vision correction for high myopia.

Key Points

Dr. Neatrour and colleagues conducted a retrospective study of 79 consecutive eyes undergoing vision correction for high myopia. Patients chose to undergo either phakic IOL (Visian Implantable Collamer Lens, STAAR Surgical) implantation or wavefront-guided, all-laser LASIK with a femtosecond laser and iris registration (CustomVue with IntraLase FS, Advanced Medical Optics [AMO]) after receiving recommendations from the ophthalmologist.

Ten patients (18 eyes) opted to have ICLs implanted. Average patient age in this group was 34 years (range, 22 to 45 years).

The mean spherical equivalent was significantly higher for the ICL group, at –10.75 D versus –6.35 D for the LASIK group. Mean astigmatism was slightly higher in the ICL group, at 1.13 D versus 0.91 D for the LASIK group.

At 3 months, UCVA was better among patients in the phakic-lens group than among patients in the LASIK group at four levels: 20/15 or better, 20/20 or better, 20/25 or better, and 20/40 or better. When measured at 6 months, however, UCVA was better in the LASIK group at all but the 20/15-or-better level.

"When we looked at safety, in terms of losing vision, we found only one [LASIK group] eye that lost one line of vision," Dr. Neatrour said. "In terms of gaining two lines or more of BSCVA, we found that the ICL surpassed [LASIK]. When we looked at accuracy-being within 0.5 D is the key goal-we saw ICLs again surpassing [LASIK] at 6 months. The goal of a postop UCVA being greater than or equal to the preop BSCVA found ICLs, again, ahead of [LASIK]."

Contrast sensitivity with and without glare improved similarly from preoperative levels in both groups, with the ICL group seeing slightly better results than the LASIK group but more improvements seen in the LASIK group.