Comparison of long-term outcomes between implantable collamer lens V4c and FS-LASIK for myopia correction with presbyopia

Abstract

Abstract Purpose: To compare the long-term safety and efficacy of monovision surgery using implantable collamer lens (ICL) V4c and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in myopic patients with early presbyopia. Setting: Eye and ENT Hospital of Fudan University,shanghai, China. Design: Case series study. Methods: 48 eyes of 24 patients were included (male/female: 10/14, mean age 45.50±3.82 years). We recorded parameters including mean spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity, intraocular pressure, presbyopic add power, visual acuity (VA) (logMAR) of dominant eyes (D-eye), non-dominant (nD-eye) eyes, and both eyes (Bi) at 0.4 m, 0.8 m, and 5 m, corneal wavefront aberration, and contrast sensitivity (CS) at the last follow-up (4.5 years, 54.00±9.77 months). Statistical significance was set at p<0.05. Results: All surgeries were uneventful. The safety indices of ICL V4c group and FS-LASIK group were 1.17±0.30 and 0.98±0.20 (p<0.05), and the efficacy indices were 0.79±0.07 and 0.52±0.07 (p<0.05) respectively. The binocular VA (logMAR) of ICL V4c group and FS-LASIK group at 5.0 m were: 0.02±0.11, 0.18±0.30; 0.8 m: 0.09±0.12, -0.01±0.11; 0.4 m: -0.02±0.06, -0.03±0.08, (p>0.05 at three distances). Compared with ICL V4c group, lower CS was observed at 1.0 cpd in the FS-LASIK group (1.07±0.31 vs. 0.80±0.51, p=0.043). Conclusions: Implantable collamer lens V4c and FS-LASIK are safe and practicable for correction of myopes with presbyopia. Compared with the FS-LASIK group, the ICL V4c group showed superior CS in nD-eyes in low spatial frequency.