Comparison of Supplementary IOL and Wavefront-Guided LASIK for Correction of Myopic Astigmatism
Purpose
To compare the visual outcomes after implantation of a supplementary intraocular lens (IOL) or wavefront-guided laser in situ keratomileusis (LASIK) for the correction of myopic astigmatism in pseudophakic patients.
Methods
This comparative case series included pseudophakic patients with myopic astigmatism submitted to the implantation of a supplementary IOL (Sulcoflex Aspheric 653L or Sulcoflex Toric 653T, Rayner Intraocular Lenses Limited) or wavefront-guided LASIK (Technolas 217z, Bausch & Lomb Surgical). 11 patients were included in each group. The postoperative refractive target was emmetropia. Over a 12-month follow-up period, uncorrected and corrected distance (UDVA and CDVA, respectively) visual acuities, spherical equivalent (SE) refraction, higher order aberrations (HOA) and contrast sensitivity with and without glare (luminance: 85 cd/m2 and 3.0 cd/m2; Optec 6500, Stereo Optical, Inc.) were evaluated.
Results
At 12 months, mean UDVA was 0.06 ± 0.04 (Sulcoflex) and 0.06 ± 0.06 (LASIK) (P=.817). Mean SE refraction was -0.03 ± 0.63 (Sulcoflex) and -0.53 ± 0.90 (LASIK) (P=.219). All eyes in the Sulcoflex group and 8 (73%) eyes in the LASIK group were within ±1.00 D of emmetropia. The mean change in SE refraction from 1 week to 12 months was 0.02 ± 0.13 D (Sulcoflex) and -0.36 ± 0.32 D (LASIK); P=003. HOA were similar between groups (HOA RMS P=.619). There was no significant difference in CS except at 18 cd (better in the Sulcoflex group; P=.004).
Conclusion
Both surgical techniques provided excellent and comparable visual outcomes. Refractive predictability and stability of SE correction were better in the Sulcoflex group. The implantation of a supplementary toric IOL is a safe and effective surgical alternative for the correction of myopic astigmatism in pseudophakic patients.