Refractive and Visual Outcomes of Surgical Treatments for High Myopia

Abstract

Objective: To present the refractive and visual outcomes of refractive surgical treatment options in high myopia.

Methods: This was a retrospective review of patients diagnosed with high myopia (manifest refractive spherical equivalent [MRSE] ≥-6.00D) who underwent one of the following procedures: laser-in-situ keratomileusis (LASIK), photorefractive keratectomy (PRK), phakic IOL implantation with the Staar Implantable Collamer Lens (ICL), or Alcon Cachet Phakic IOL. Eyes with best corrected distance vision of less than 20/30 due to amblyopia or other eye pathologies were excluded.

Results: This study evaluated 145 eyes of 77 patients: 86 eyes underwent LASIK, 37 eyes PRK, 16 eyes implanted with the ICL, and 6 eyes with Cachet lens. Preoperatively, the mean MRSE was -7.44D, -7.71D, -9.82D, and -12.08D for the LASIK, PRK, ICL, and Cachet groups respectively. At 1 year postoperatively, the mean MRSE was -0.22D, +0.23D, -0.40D, and -0.28D, respectively. The mean uncorrected distance vision (UDVA) at 1 year follow-up was 20/20 in the LASIK and PRK groups, 20/25 in the ICL and 20/30 in the Cachet, while the best corrected distance vision (BDVA) was 20/20 in all groups. An increase in spherical aberration (SA) and total higher-order aberration (HOA) was observed in LASIK (SA p=0.00; HOA p=0.00) and PRK (SA p=0.00; HOA p=0.00) but not in the ICL (SA p=0.11; HOA p=0.69) and Cachet (SA p=0.95; HOA p=0.25) groups.

Conclusion: The four refractive treatment options were effective at reducing the myopic refractive error and achieving good uncorrected distance vision. Laser refractive treatments caused an increase in spherical and higher order aberrations not seen in the phakic IOL treatments.