Optical and visual quality comparison of implantable collamer lens and femtosecond laser assisted laser in situ keratomileusis for high myopia correction
Abstract:AIM: To compare clinical outcomes and refractive stability of implantable collamer lens (ICL) implantation and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia correction.
METHODS: The Optical Quality Analysis System (OQAS) was used to evaluate clinical outcomes objectively after operation for high myopia correction. We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety index, eff… Show more
“…22 articles were further excluded due to the following reasons: study in Czech (n=1), studies where only ICL implantation was performed (n=2), studies where subjects were children (n=2), studies recruited subjects of low or moderate myopia, or emmetropia (n=16), studies of iris-fixated Artiflex lens (n=1). Finally, 5 studies [ 13 , 16 , 18 , 20 , 21 ](involving 555 eyes) were included in this meta-analysis. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Three studies [ 16 , 18 , 20 ] assessed change in Snellen lines of CDVA (Fig. 3 ), the heterogeneity across three studies was small (I 2 =50%), so a fixed-effects model was applied.…”
Purpose
To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults.
Methods
A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes.
Results
Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03).
Conclusion
Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.
“…22 articles were further excluded due to the following reasons: study in Czech (n=1), studies where only ICL implantation was performed (n=2), studies where subjects were children (n=2), studies recruited subjects of low or moderate myopia, or emmetropia (n=16), studies of iris-fixated Artiflex lens (n=1). Finally, 5 studies [ 13 , 16 , 18 , 20 , 21 ](involving 555 eyes) were included in this meta-analysis. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Three studies [ 16 , 18 , 20 ] assessed change in Snellen lines of CDVA (Fig. 3 ), the heterogeneity across three studies was small (I 2 =50%), so a fixed-effects model was applied.…”
Purpose
To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults.
Methods
A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes.
Results
Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03).
Conclusion
Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.
“…16,17,24 Mean postoperative UDVA values were in favor after T-ICL over LASIK in 3 articles, but only Jiang et al showed significance. 20,25,26 Several studies reported a significantly higher predictability within ±0.5 D and ±1.0 D in ICL over LASIK for moderate to high myopia and within ±1.0 D for high myopia. 16,17,21,24 Jiang et al reported a remarkable difference of predictability within ±0.5 D in favor of ICL (ICL 98% vs FS-LASIK 69%, significance unknown).…”
Comparative reports on (T-)ICL are either equal or superior over LASIK in terms of visual performance (safety, efficacy, predictability, and stability), higher-order aberrations, and contrast sensitivity for myopia and astigmatism >−3 D.
“…Alternative optical quality parameters are used to quantify visual quality after presbyopia-correcting IOLs implantation in eyes that have had refractive surgery, including the modulation transfer function (MTF) cutoff frequency, the objective scatter index (OSI) and the strehl ratio (SR). MTF is obtained by Fourier transform from the point spread function (PSF) and MTF cutoff is used to express visual quality, referring to the frequency at which the MTF reaches 1% contrast ( 39 ). OSI is defined as the amount of the light outside the double-pass retinal intensity PSF image in the peripheral zone vs. that on the central zone ( 40 ).…”
PurposeTo assess the efficacy, safety, and predictability of presbyopia-correcting intraocular lenses (IOLs) in cataract patients with previous corneal refractive surgery.MethodsA systematic literature search was performed to identify studies evaluating the clinical outcomes of presbyopia-correcting IOLs implantation in cataract surgery after laser refractive surgery. Outcomes were efficacy, safety and predictability parameters.ResultsThe authors identified 13 studies, involving a total of 128 patients and 445 eyes. Presbyopia-correcting IOLs were effective at improving distance, intermediate and near visual acuity aftercataract surgery. The proportion of post-laser surgery eyes with uncorrected distance visual acuity (UDVA) ≥ 20/25 was 0.82 [95% confidence interval (CI), 0.74-0.90] and the pooled rates of spectacle independence at near, intermediate, and far distances were 0.98 (95% CI, 0.94-1.00), 0.99 (95% CI, 0.95-1.00) and 0.78 (95% CI, 0.65-0.94) respectively. The percentage of participants who suffered from halos and glare was 0.40 (95% CI, 0.25-0.64) and 0.31 (95% CI, 0.16-0.60), respectively. The predictability had a percentage of 0.66 (95% CI, 0.57-0.75) and 0.90 (95% CI, 0.85-0.96) of eyes within ±0.5 diopters (D) and ±1.0 D from the targeted spherical equivalent.ConclusionsPresbyopia-correcting IOLs provide satisfactory results in terms of efficacy, safety and predictability in patients with previous corneal refractive surgery, but have a higher risk of photopic side effects such as halos and glare.
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