Comparison of implantable contact lens and laser assisted in situ keratomileusis for moderate to high myopia.
OBJECTIVE
To compare the results of laser assisted in situ keratomileusis (LASIK) and implantable contact lenses (ICL) in the correction of moderate/high myopia.


METHODS
Five hundred fifty-nine LASIK eyes from the Davis Duehr Eye Center, Madison, WI, and 210 ICL eyes from the 14-site U.S. FDA Clinical Trial for ICL for Myopia were compared. These series were concurrently operated on with 8 to 12 D of preoperative myopia and were examined at 1 day, 1 week, 1 month, 6 months, and 1 year postoperatively. The mean baseline myopia was slightly higher in the ICL group, (ICL: -9.8 +/- 1.7 D; LASIK: -9.1 +/- 0.97 D). BSCVA, UCVA, and refractions were collected prospectively in both series.


RESULTS
Every index of BSCVA, UCVA, predictability of refraction, and stability of refraction studied favored the ICL over the LASIK procedure. All but one of the indices (UCVA % 20/40 or better) were statistically significant in at least half of the time periods studied. At 6-month follow-up, both the loss of two or more lines (ICL: 0%; LASIK: 2%; p = 0.05) and gain of two or more lines (ICL: 7%; LASIK: 3%; p = 0.04) of BSCVA were better with the ICL. Similarly, efficacy outcomes with the ICL were better with predictability (attempted versus achieved +/-1.0 D) of the ICL at 90%; 76% with LASIK (p < 0.001). In this highly myopic series, UCVA 20/20 or better was 50% with ICL compared with 35% with LASIK (p < 0.001). No serious complications occurred in either series of cases.


CONCLUSIONS
The ICL was safer and more effective than LASIK and appears to be a viable alternative to corneal refractive excimer surgery in the treatment of moderate to high myopia.
Sanders
Donald R
DR
Center for Clinical Research, Elmhurst, Illinois 60126, USA. drsmd@drsmd.com
Vukich
John A
JA
D000328:Adult; D000368:Aged; D003261:Contact Lenses / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects; D012086:Reoperation; D012449:Safety; D016896:Treatment Outcome