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Comparison of long-term visual quality after keratorefractive lenticule extraction and implantable collamer lens V4c
Biyun Zhan1, Yangyi Huang, Xun Chen
1From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China (Zhan, Huang, Chen, Aruma, Cheng, Wang, Zhou); NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China (Zhan, Huang, Chen, Aruma, Cheng, Wang, Zhou); Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China (Zhan, Huang, Chen, Aruma, Cheng, Wang, Zhou); Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China (Zhan, Huang, Chen, Aruma, Cheng, Wang, Zhou).
Purpose:
To compare the long-term refractive outcomes and visual quality after keratorefractive lenticule extraction (KLEx) and EVO-implantable collamer lens (ICL) implantation for high myopia.
Setting:
Eye & ENT Hospital of Fudan University, Shanghai, China.
Design:
Retrospective study.
Methods:
This study included 31 KLEx-treated patients (31 eyes, spherical equivalent: -7.62 ± 1.22 diopters [D]) and 32 ICL-treated patients (32 eyes, spherical equivalent: -8.22 ± 1.18 D). Refractive outcomes and objective visual quality were examined. Subjective visual quality was evaluated by a customized questionnaire. Patients' satisfaction was graded.
Results:
5 years postoperatively, the efficacy (KLEx: 0.96 ± 0.20; ICL: 1.03 ± 0.20; P = .164) and safety indices (KLEx: 1.12 ± 0.20; ICL: 1.21 ± 0.19; P = .067) were comparable. Statistically higher proportions of ICL-treated eyes achieved a postoperative uncorrected distance visual acuity of 20/20 or better ( P = .035). Refractive predictability was similar between the 2 groups ( P = .947), whereas more KLEx-treated eyes had myopic refractive errors ( P < .001). Total coma was significantly higher after KLEx ( P = .020), and greater total trefoil was observed after ICL implantation ( P = .006). Haloes were the primary visual disturbance in both groups (KLEx: 64.5%; ICL: 93.8%). The incidences of haloes ( P < .001), glare ( P = .004), and starbursts ( P = .043) were notably higher after ICL implantation. The patient's satisfaction scores were similar (KLEx: 9.10 ± 1.27; ICL: 9.10 ± 1.27; P = .894).
Conclusions:
For high myopia, EVO-ICL yielded better long-term refractive outcomes than KLEx. Haloes were the chief concern in both groups, with a significantly higher incidence after ICL implantation.
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