title: Meta-analysis of randomized controlled trials comparing excimer laser and phakic intraocular lenses for myopia between 6.0 and 20.0 diopters.
abstract: OBJECTIVE
  Meta-analysis of randomized controlled trials (RCTs) comparing excimer laser refractive surgery and phakic intraocular lenses (pIOLs) for the correction of myopia between 6.0 and 20.0 diopters (D). pIOLs are an alternative surgical option to excimer laser for these patients. The evidence base comparing these 2 methods has never been assessed systematically.
  
  
  METHODS
  Cochrane Eyes and Vision Group, International. We performed a comprehensive literature search using the Cochrane Collaboration methodology to identify RCTs. A meta-analysis on the results of RCTs was performed. We analyzed data for efficacy outcomes, accuracy outcomes, safety outcomes, adverse effects, and quality-of-life measures.
  
  
  RESULTS
  This review included 3 RCTs with a total of 228 eyes. The range of myopia was 6.0 to 20.0 D with up to 4.0 D of astigmatism. The pIOL group was less likely to lose 2 or more lines of best spectacle-corrected visual acuity at 12 months (odds ratio, 0.35; 95% confidence interval, 0.19-0.66, P = 0.001). PIOL surgery scored more highly on patient satisfaction/preference questionnaires.
  
  
  CONCLUSIONS
  The results of this systematic review show that pIOLs are safer within 1 year of follow-up compared with excimer laser surgical correction for myopia between 6 and 20 D. There is weaker evidence for superior visual quality in pIOL recipients. Further RCTs adequately powered for subgroup analysis with long-term follow-up are necessary to establish the ideal myopic range for excimer laser and pIOL treatments.
authors.affiliation: Department of External Disease, Moorfields Eye Hospital, London, United Kingdom. abarsam@hotmail.com
authors.forename: Allon
authors.initials: A
authors.lastname: Barsam
authors.forename: Bruce D S
authors.initials: BD
authors.lastname: Allan
mesh_terms: D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D009216:Myopia / Q000601:surgery*; D047728:Myopia, Degenerative; D054120:Phakic Intraocular Lenses; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology