title: Foldable iris-fixated phakic intraocular lens vs femtosecond laser-assisted LASIK for myopia between -6.00 and -9.00 diopters.
abstract: OBJECTIVE
  To compare visual, refractive, and clinical outcomes of foldable iris-fixated phakic intraocular lens (PIOL) implantation versus femtosecond laser-assisted LASIK for myopia between -6.00 and -9.00 diopters (D).
  
  
  METHODS
  Forty-six myopic patients were randomized to undergo bilateral Artiflex (Ophtec BV) PIOL implantation or bilateral femtosecond laser-assisted conventional LASIK with the VISX S2 (Abbott Medical Optics). Refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity, contrast sensitivity, corneal endothelial cell count, rate of retreatment, and complications were compared.
  
  
  RESULTS
  Twelve months after surgery, no statistically significant differences were noted in spherical equivalent refraction (P=.19) or UDVA (P=.28), whereas CDVA was better in the PIOL group (P<.001). Spherical equivalent refraction was within ±0.50 D in 42 (91.3%) LASIK eyes and 41 (89.1%) PIOL eyes (P>.99). The percentage of eyes gaining lines of CDVA was significantly higher in the PIOL group (50.0% vs 8.7%; P<.001). Contrast sensitivity was better for PIOL eyes at 1.5 cycles per degree (cpd) (P=.03) and 6 cpd (P=.008). The LASIK eyes showed a mean endothelial cell count increase of 3.7%±2.8%, whereas PIOL eyes showed a mean decrease of 9.1%±2.0% (P<.001). The rate of retreatment was similar (P=.37), and no serious complications occurred in either group.
  
  
  CONCLUSIONS
  The Artiflex PIOL provided better CDVA and contrast sensitivity at high spatial frequencies than femtosecond laser-assisted conventional LASIK, suggesting that PIOL implantation is a reasonable option for myopia between -6.00 and -9.00 D.
authors.affiliation: Refractive Surgery Department, Clinica Oftalmologica Marques de Sotelo, Spain. cesar.albarran@gmail.com
authors.forename: César
authors.initials: C
authors.lastname: Albarrán-Diego
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Muñoz
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferrer-Blasco
authors.forename: Santiago
authors.initials: S
authors.lastname: García-Lázaro
authors.forename: Lurdes
authors.initials: L
authors.lastname: Belda-Salmerón
mesh_terms: D000328:Adult; D002452:Cell Count; D015350:Contrast Sensitivity / Q000502:physiology; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011446:Prospective Studies; D011474:Prosthesis Design; D012029:Refraction, Ocular / Q000502:physiology; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult