Quality of Vision After 3 Treatment Modalities for Myopic Astigmatism: Matched Comparative Study

Sunday, April 19, 2015: 3:01 PM
Room 3 (San Diego Convention Center)
Sri Ganesh, MBBS, MS, DNB

Purpose
To  describe the initial results of a comparison study between 3 treatment modalities- Visian STAAR T-ICL (V4c model), Femto-LASIK and ReLEx SMILE in terms of visual outcomes and patient satisfaction for low to moderate myopic astigmatism(SE -3 to -8D with astigmatism upto-3 D).

Methods
A total of 45 eyes, with 15 eyes in each group were treated with  Visian T-ICL (Group-1), Femto-LASIK (Group-2) and ReLEx SMILE (Group-3)  procedures. The eyes were matched for age and refractive error. Main outcomes measured were UCVA, change in lines of CDVA, safety and efficacy, predictability, contrast sensitivity (F.A.C.T), higher-order aberrations (HOA), endothelial cell density, dry eye, patient satisfaction and spectacle independence. Mean follow-up of all 3 groups was at least 1 month.

Results
At 1 month, % of eyes with UCVA 20/20 or better was 95%, 92 % and 96 % in group 1, 2 and 3 respectively. In T-ICL and SMILE groups 33% eyes gained 1 line of CDVA,  2 lines gain was only in T-ICL group. 4 eyes lost 1 line in F-LASIK group. All eyes in T-ICL and F-LASIK groups were within ±0.5 D, against 13 (87%) in SMILE group. Improvement in contrast sensitivity and reduction in HOA from 0.219 to 0.134 RMS(µ) was seen  in T-ICL group.  No significant difference was observed in ECD between 3 groups.

Conclusion
Initial observations reflect good safety and predictability of all three modalities. Improvement in contrast, decrease in HOA and  less dry eye appear to contribute to high definition vision with T-ICL and highest patient satisfaction.