Purpose: To evaluate the visual quality achieved in patients undergoing standard or modified implantable Collamer lens (ICL) to correct residual myopic error after laser-assisted in situ keratomileusis (LASIK) surgery.
Methods: The adaptive optics visual simulator was used to simulate LASIK surgery of moderate and high myopia with a myopic regression corrected by a standard and modified ICL. Visual acuity (VA) and contrast sensitivity (CS) were measured in 14 subjects at 3- and 4.5-mm pupil. Point spread function and simulated retinal images were calculated.
Results: Comparing LASIK plus standard ICL and LASIK plus modified ICL simulations, for moderate myopia, VA improvement was less than 1 line in all VA contrasts and both pupils evaluated. No statistically significant differences were found in CS between the simulations at any spatial frequency evaluated and for 3-mm pupil (p>0.05), but differences were significant at 4.5-mm pupil (p<0.05). For high myopia, the VA improvement was less than 1 line at 3-mm pupil, although it increased 2 or more lines at 4.5-mm pupil. Statistically significant differences were found in CS between the simulations for all spatial frequencies and both pupils evaluated (p<0.05), except for low and medium spatial frequencies at 3-mm pupil (p>0.05).
Conclusions: These outcomes suggest that an ICL is a good option to correct the myopic residual error after myopic LASIK. When the ICL's spherical aberration is modified, the post-LASIK eyes of high myopia are the most benefited, as these eyes are more aberrated than after moderate myopic LASIK.