Free Papers

A critical comparison exploring the pros and cons of refractive laser surgery vs a posterior chamber phakic intraocular lens for myopia and myopic astigmatism

Free Paper Details

First Author: H.Delbeke BELGIUM

Co Author(s):    S. Goes                    

Abstract Details

Purpose:

To provide a non-industry driven accurate overview of current data comparing refractive lasers to a posterior chamber phakic intraocular lens, more specifically the Visian implantable collamer lens (ICL) to treat myopia and myopic astigmatism.

Setting:

Department of Ophthalmology, University Hospitals Leuven, Belgium

Methods:

An electronic literature search using PubMed, Embase, Web of Science and Cochrane Library databases was performed on December 17th, 2019. After deduplication and exclusion 21 studies were included for further analysis on refractive efficacy, safety, predictability and stability as well as differences in contrast sensitivity, higher order aberrations and postoperative complications.

Results:

When comparing ICL to laser-assisted in-situ keratomileusis (LASIK), most articles were either comparable or in favor of (toric-) ICL with less induction of higher-order aberrations, a better post-operative contrast sensitivity function and less secondary surgeries. Small incision lenticule extraction (SMILE) showed comparable outcomes for all myopia ranges and a higher efficacy and predictability within 0.5D compared to toric-ICL in myopic astigmatism within the range of -3 to -8 D spherical equivalent with a minimum of astigmatism of -0.75 D. Less unexpected, (toric-) ICL have a better outcome for myopia above -6D compared to corneal surface ablation laser surgery.

Conclusions:

(Toric-) ICL is superior to surface ablations for high myopia and equal or slightly superior compared to LASIK for myopia above -3D. (Toric-) ICL might be an alternative to SMILE with comparable outcomes for myopia of all ranges, but further investigation is needed.

Financial Disclosure:

-