Visual outcomes after small incision lenticule extraction and implantable collamer lens V4c for moderate myopia: 1-year results

Graefes Arch Clin Exp Ophthalmol. 2021 Aug;259(8):2431-2440. doi: 10.1007/s00417-020-04982-4. Epub 2021 Mar 4.

Abstract

Purpose: To compare 1-year visual outcomes after implantable collamer lens V4c (EVO-ICL) implantation and small incision lenticule extraction (SMILE) for moderate myopia.

Methods: In this retrospective study, 67 eyes of 39 patients with a preoperative manifest refraction spherical equivalent between - 3.00 and - 6.00 diopters (D) were selected from a database of SMILE and ICL implantation procedures performed from April 2018 to December 2018. Thirty-two eyes of 20 patients underwent EVO-ICL implantation, and 35 eyes of 19 patients underwent SMILE. At the routine 1-year follow-up appointment, all selected patients were examined for higher-order ocular aberrations, retinal image quality, and a quality of vision (QoV) questionnaire. This data was then analyzed.

Results: No complications were observed. Uncorrected and corrected visual acuities at 1 year after surgery were - 0.13 ± 0.07 and - 0.15 ± 0.06 logMAR in the SMILE group, and - 0.10 ± 0.07 and - 0.16 ± 0.05 logMAR in the ICL group. Twenty-nine eyes (90.6%) which underwent ICL implantation and 34 eyes (97.1%) which underwent SMILE were within ± 0.5 D of the attempted spherical equivalent (P = 0.49). Changes in coma after ICL were significantly less than after SMILE (P = 0.002). The leading complaints after ICL and SMILE were halos (84.4%) and blurred vision (65.7%), respectively.

Conclusions: Both SMILE and ICL implantation provided good safety, efficacy, and predictability in correcting moderate myopia. The subjective visual complaints consisted mainly of halos after ICL and starbursts and blurred vision after SMILE.

Keywords: Implantable collamer lens V4c; Moderate myopia; Small incision lenticule extraction; Visual quality.

MeSH terms

  • Follow-Up Studies
  • Humans
  • Myopia* / surgery
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity