Visual performance after implantable collamer lens implantation and wavefront-guided laser in situ keratomileusis for high myopia

Am J Ophthalmol. 2009 Jul;148(1):164-70.e1. doi: 10.1016/j.ajo.2009.02.001. Epub 2009 Apr 17.


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 < or = -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.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Contrast Sensitivity / physiology
  • Corneal Topography
  • Female
  • Humans
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer / therapeutic use
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Myopia, Degenerative / surgery*
  • Phakic Intraocular Lenses*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Visual Acuity / physiology*
  • Young Adult