Journal of Cataract & Refractive Surgery
Volume 37, Issue 2 , Pages 370-377, February 2011

Comparison of wavefront-guided photorefractive keratectomy and foldable iris-fixated phakic intraocular lens implantation for low to moderate myopia

Presented in part at the Symposium on Innovations in Cataract and Refractive Surgery, Fyodorov Microsurgery Complex, Moscow, Russia, November 2007.

From the Department of Ophthalmology, Haaglanden Medical Center (Joosse, Snoek, van Minderhout), The Hague, and the Department of Ophthalmology of the Leiden University Medical Centre (Snoek), Leiden, The Netherlands

Received 3 May 2010; received in revised form 19 August 2010; accepted 19 August 2010.

Purpose

To compare and evaluate the visual and refractive outcomes of myopic wavefront-guided photorefractive keratectomy (PRK) and foldable phakic intraocular lens (pIOL) implantation for myopia.

Setting

Department of Ophthalmology, Haaglanden Medical Center, The Hague, The Netherlands.

Design

Comparative case series.

Methods

The differences in visual acuity and residual refractive outcomes after wavefront-guided PRK and Artiflex foldable pIOL implantation were compared in eyes with low to moderate myopia (spherical error −4.0 to −7.0 diopters [D]; maximum cylinder 2.25 D). One-year follow-up results are presented.

Results

At 1 year postoperatively, the mean decimal Snellen uncorrected distance visual acuity was 1.05 ± 0.21 (SD) in the PRK group (60 eyes) and 1.04 ± 0.21 in the pIOL group (33 eyes) and the mean corrected distance visual acuity (CDVA), 1.21 ± 0.18 and 1.24 ± 0.13, respectively. In the PRK group, 21.7% of eyes lost 1 to 3 lines of CDVA and 11.7% of eyes gained 1 or 2 lines. In the pIOL group, no eye lost lines of CDVA and 42% gained 1 or 2 lines. At 1 year, 80.0% of eyes in the PRK group and 90.9% of eyes in the pIOL group were within ±0.50 D of the spherical equivalent.

Conclusion

There were no statistically significant differences in safety and efficacy between the pIOL group and the PRK group at 1 year. However, the percentage of eyes that gained lines of CDVA was significantly higher in the pIOL group.

Financial Disclosure

No author has a financial or proprietary interest in any material or method mentioned.

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PII: S0886-3350(10)01757-8

doi:10.1016/j.jcrs.2010.08.051

Journal of Cataract & Refractive Surgery
Volume 37, Issue 2 , Pages 370-377, February 2011