Comparison of objective and subjective visual quality early after implantable collamer lens V4c (ICL V4c) and small incision lenticule extraction (SMILE) for high myopia correction

Abstract

Purpose To investigate differences in the objective and subjective visual quality of patients with high myopia following implantable collamer lens V4c (ICL V4c) versus small incision lenticule extraction (SMILE) early postoperatively. Methods This prospective analysis included 94 eyes of 57 patients (8 males) in the ICL V4c group (mean spherical equivalent (SE), −8.07 ± 1.03 dioptres (D)) and 103 eyes of 57 patients (13 males) in the SMILE group (mean SE, −7.85 ± 0.78 D). Refractive parameters and wavefront aberrations were recorded preoperatively and 6 months postoperatively. Subjective visual quality was scored with the Quality of Vision questionnaire, and operation satisfaction was evaluated 6 months postoperatively. Results At 6 months postoperatively, the efficacy index was 1.17 ± 0.16 in the ICL and 1.09 ± 0.20 in the SMILE group; the safety index was 1.21 ± 0.18 in the ICL and 1.12 ± 0.16 in the SMILE group. A significant increase in total higher‐order aberrations (HOAs) in both the ICL and SMILE groups was observed, but to a lesser degree in ICL (p < 0.05). In the ICL group, trefoil significantly increased (p < 0.05), whereas in the SMILE group, coma, trefoil and spherical aberration significantly increased (p < 0.05). Glare, haloes and blurred vision had the highest incidences after both types of surgery, and postoperative haloes were significantly more common following ICL; 96.1% of ICL‐treated and 94.9% of SMILE‐treated patients were satisfied with their visual outcomes. Conclusion ICL V4c caused lower HOAs induction than SMILE. Despite the postoperative visual disturbances, both ICL and SMILE provided good efficacy, safety, predictability and high satisfaction in correcting high myopia.

Long-term Visual Quality after Small Incision Lenticule Extraction (SMILE) and Laser Epithelial Keratomileusis (LASEK) for Low Myopia

“…In this study, the main visual disturbances were starburst, halo, and vision uctuation two years after the surgery. These symptoms were not reported to disturb patients' daily life except for inconvenience when driving at night postoperatively, which is consistent with the ndings of Wei et al [19] Our study has some limitations. First, we observed only the changes in the corneal aberrations, whereas the effect of total ocular aberrations on visual quality was not analyzed.…”

In vivo optical quality of posterior-chamber phakic implantable collamer lenses with a central port

“…This agrees with that indicated by Wan et al [ 17 ] (size and orientation of the corneal incision) and Pérez-Vives et al [ 26 ] (tilt and decentration). Specifically, Wei et al [ 19 ] reported a mean value of 0.26 ± 0.07 μm for a 5.0-mm pupil, which was about half to that reported by Qin et al [ 16 ]. However, it must be pointed out that the mean SE in the study of Qin et al [ 16 ] was larger (about − 14 D) than that reported by Wei et al [ 19 ] (about − 8 D).…”

“…Wei et al [ 19 ] measured the optical quality in 94 eyes using the WASCA aberrometer at 6 months postsurgery. These authors reported a significant increase of HOAs after the surgery ( P < 0.05) indicating that this increase might be caused by the procedure itself or the innate optical properties of the lenses.…”

Pure ICL Implantation: A Novel Ophthalmic Viscosurgical Device-Free Technique

“…Through the continuous development and improvement in ICL implantation technology, the EVO-ICL implant with a central hole has become the most mainstream surgical method for intraocular refractive surgery, favoured by patients with high myopia and other refractive errors who are not satis ed with or do not qualify for corneal laser surgery [20] . The safety and e cacy of ICL implantation have been widely recognised [3,12] . During standard ICL implantation procedures, OVDs should be injected into the ICL implant container and the eyes to reduce the potential for damage to the corneal endothelium and transparent lens and to maintain the AC space for surgery.…”

“…Visian ICL TM (STAAR Surgical, Nidau, Switzerland) is a type of posterior chamber PIOL [2][3] , and previous studies have shown that EVO-ICL (an implantable collamer lens with a centre hole) implantation is satisfactorily safe [4] . EVO-ICL implantation can reduce the induction of high-order aberrations and improve contrast sensitivity [5] .…”