Comparison of Supplementary IOL and Wavefront-Guided LASIK for Correction of Myopic Astigmatism
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.
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.
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).
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.