title: Matched optical quality comparison of 3-year results of PRK-MMC and phakic IOL implantation in the correction of high myopia.
abstract: OBJECTIVE
  To compare 3-year results of PRK-MMC and phakic intraocular lens (PIOL) implantation in patients with >8.0 diopters (D) of myopia.
  
  
  METHODS
  This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK-MMC (group B). This report compares 3-year treatment results in these two groups.
  
  
  RESULTS
  At 3 years after surgery, uncorrected visual acuity was 0.02±0.06 LogMAR in group A and 0.04±0.07 LogMAR in group B (P=0.639). Mean best corrected visual acuity in group A (0.004±0.02) was better than group B (0.03±0.07 LogMAR) (P=0.035). Mean manifest refraction spherical equivalent was -0.16±0.21 and -0.09±0.20D (P=0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P=0.024). CS6 decreased significantly only in group B (P=0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16±0.18 μm, P=0.003) and reduction in spherical aberration (SA; 0.16±0.08 μm, P<0.001) were statistically significant. In group B, the reduction in vertical coma (P=0.052), and increases in horizontal coma (P=0.044), coma (P<0.001), SA (P<0.001), and total higher order aberrations (P<0.001) were significant after surgery.
  
  
  CONCLUSIONS
  Based on 3-year results, PIOL implantation is a better choice than PRK-MMC for treating patients with >8.0D myopia. However, for patients with an inadequate aqueous depth, PRK-MMC can be an acceptable treatment option with a potential for decreased quality of vision.
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Miraftab
authors.affiliation: Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Hashemi
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.
authors.forename: S
authors.initials: S
authors.lastname: Asgari
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D018903:Photorefractive Keratectomy / Q000379:methods*; D012029:Refraction, Ocular / Q000502:physiology; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin