Higher-order aberrations after iris-fixated foldable phakic intraocular lens implantation and wavefront-guided photorefractive keratectomy for the correction of myopia

To compare higher-order aberrations (HOAs) after foldable phakic intraocular lens (pIOL) implantation and wavefront-guided photorefractive keratectomy (PRK) for the correction of myopia.

Department of Ophthalmology, Medisch Centrum Haaglanden, Den Haag, The Netherlands.

Comparative case series.

This retrospective comparative case series comprised eyes that had implantation of an Artiflex foldable pIOL or wavefront-guided PRK. Preoperative and postoperative refractive data, pupil diameter, endothelial cell density, and higher-order aberrations (HOAs) were measured and compared.

The median follow-up was 13 months in the pIOL group and 10 months in the PRK group. The mean spherical equivalent (SE) in the pIOL group was -5.50 diopters (D) ± 1.05 (SD) (range -3.25 to -7.13 D) preoperatively and -0.26 ± 0.28 D (range -0.88 to 0.38 D) postoperatively and the mean in the PRK group, -5.72 ± 0.88 D (range -4.25 to -7.50 D) and -0.03 ± 0.42 D (range -0.75 to 1.00 D), respectively. The postoperative SE was within ±0.50 D in 86.4% of eyes and 85.2% of eyes, respectively. Postoperatively, the significant changes in the pIOL group and the PRK group, respectively, were as follows: total HOAs, 0.03 μm and 0.26 μm (P = .001); trefoil-y, 0.09 μm and -0.04 μm (P = .004); spherical aberration, -0.05 μm and 0.21 μm (P = .002).

Foldable pIOL implantation increased total HOAs and spherical aberration less than wavefront-guided PRK to correct low to moderate myopia, suggesting foldable pIOL implantation maintains the cornea's prolate shape better.