[Comparison of clinical results between LASIK method and ICL implantation in high myopia]

In a retrospective study the authors evaluate clinical results of the LASIK (laser in situ keratomileusis) and the implantation of the implantable posterior chamber contact lens phakic IOL (ICL) (STAAR Surgical) to correct high myopia. The purpose of the study was to assess which of those two methods is more reliable in patients to correct myopia in the range -10.0 to -23.0 diopters. The LASIK method was presented of a group of 70 eyes of 48 patients with preoperative spherical equivalent average of -12.9 +/- 3.8 diopters (Dsf) and average astigmatism of -0.99 +/- 1.2 cylindrical diopters (Dcyl). The group was divided into two parts: one part was with the desired postoperative emmetropia--46 eyes (65.7%), and part two was with the desired postoperative residual myopia up to -3.0 Dsf--24 eyes (34.3%). The method of ICL implantation was presented of a group of 36 eyes of 21 patients with preoperative spherical equivalent average of -15.21 +/- 4.0 Dsf and average astigmatism of -0.92 +/- 0.69 Dcyl. Also this group was divided into two parts: One part was with the desired postoperative emmetropia--25 eyes (69.4%), and part two was with the desired postoperative residual myopia up to -3.0 Dsf--11 eyes (30.6%). The developments of postoperative refraction in time (1 week to 3 years after the surgery), the final postoperative refraction and its stability and (6 months to 3 years after the surgery) as well as the occurrence of complications in both studied groups were evaluated. In the assessment of the postoperative refraction development in groups of desired emmetropia, the average uncorrected visual acuity (UCVA), average postoperative spherical equivalent and astigmatism were evaluated. In the groups with desired residual myopia the average best-corrected visual acuity (BCVA), average postoperative spherical equivalent, and astigmatism were followed. Three years after the surgery in groups with desired emmetropia, the average postoperative spherical equivalent was -0.99 Dsf and reduction of myopia by 92.0% in the LASIK method, and -0.52 Dsf and reduction of myopia by 96.1% in ICL implantation respectively. In cases of desired residual myopia those final values were -1.74 Dsf with reduction of myopia by 86% for LASIK, and -1.58 Dsf with reduction myopia by 90.7% for ICL implantation. Final postoperative BCVA (given in lines of Snellen optotypes) was in 1.7% (1 eye) loss of 2 lines, in 17.1% (12 eyes) 1 line loss, in 55.7% (39 eyes) without change, in 22.9% (16 eyes) improvement by one line. In ICL implantation, the BCVA was unchanged in 25% (9 eyes), in 72.3% (26 eyes) improved by 1 line, and in 1 eye improved by 2 lines. In the group with LASIK method, in 17.1% (12 eyes) a reoperation followed, and in the group with ICL implantation, in 2.7% (1 eye) the other operation followed (ICL explantation). From the results emerged that for high myopia over -10 Dsf is the ICL implantation more appropriate because of its faster postoperative visual rehabilitation, more stabile and better final postoperative refraction and lower complications ratio.