Visual outcomes of implantable Collamer lens and laserassisted in situ keratomileusis for all levels of myopiaOA

AIM:To compare the clinical outcomes of the current V4c model of the myopic implantable Collamer lens(ICL)with those of laser in situ keratomileusis(LASIK)for the correction of myopia ranging from−2.0 to−18.0 diopters(D).METHODS:This prospective,non-randomized study enrolled participants who underwent either LASIK or implantation of the ICL V4c at Bolor Melmii Eye Hospital.In the LASIK group,participants received Intralase LASIK(I-LASIK)using the Intralase FS-200 femtosecond laser and the MEL-80 excimer laser.Each group comprised the same number of participants and eyes(38 participants,73 eyes).RESULTS:A total of 146 eyes from 76 participants were analyzed.Among the LASIK group,76.3%were female,with a mean age at surgery of 29.76±5.95y(range,20–43y).In the ICL group,92.1%were female,with a mean age of 31.59±8.32y(range,20–49y).Preoperative best-corrected visual acuity(BCVA)did not differ significantly between the LASIK and ICL groups(P=0.68).Postoperatively,the ICL group consistently demonstrated better BCVA(20/20 or better)at all follow-up points,with statistically significant differences observed at 1d(56.2%vs 30.1%,P=0.003)and 3mo(54.8%vs 32.9%,P=0.012).The mean BCVA improvement also favored the ICL group for up to 6mo postoperatively.A higher proportion of eyes in the ICL group achieved uncorrected distance visual acuity(UDVA)of 20/20 or better at 1mo(50.7%vs 41.1%,P=0.319)and 6mo(57.5%vs 43.8%,P=0.136),although these differences were not statistically significant.Predictability was comparable between the groups,except at 6mo,where fewer ICL-treated eyes were within±0.5 D of the intended correction(49.3%vs 64.4%,P=0.094).Nevertheless,both groups achieved identical outcomes within±1.0 D(90.4%,P=1.000).Between 1 and 6mo,78.1%of eyes in the ICL group showed a change in spherical equivalent refraction of no more than 0.5 D,compared to 65.8%in the LASIK group.Refraction stability,defined as a change of less than 1.0 D,remained good in both groups throughout all followup periods.CONCLUSION:Both LASIK and ICL implantation leads to significant improvements in visual outcomes,with early postoperative gains observed in both groups.However,the ICL group demonstrates greater long-term improvement in BCVA compared to the LASIK group,particularly among participants with higher degrees of myopia.Visual outcomes in both groups stabilized by 6mo postoperatively.