Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia

Am J Ophthalmol. 2012 Jun;153(6):1178-86.e1. doi: 10.1016/j.ajo.2011.12.005. Epub 2012 Feb 23.


Purpose: 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.

Design: Retrospective observational case study.

Patients and methods: 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.

Results: 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).

Conclusions: 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.

Publication types

  • Comparative Study

MeSH terms

  • Aberrometry
  • Adolescent
  • Adult
  • Contrast Sensitivity / physiology
  • Cornea / physiopathology
  • Corneal Wavefront Aberration / physiopathology
  • Female
  • Humans
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer / therapeutic use*
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Myopia / classification
  • Myopia / physiopathology
  • Myopia / surgery*
  • Phakic Intraocular Lenses*
  • Posterior Eye Segment / surgery*
  • Pseudophakia / physiopathology
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Visual Acuity / physiology*
  • Young Adult