Visual outcomes of combined use of implantable collamer lens implantation and laser corneal visual correction for myopia over -18.00 diopters

Abstract

Purpose: This retrospective comparative case series explores visual outcomes in patients with extreme myopia receiving an implantable collamer lens (ICL) at –18.00 diopters (D), with central port, followed by bioptics via laser vision correction (LASIK or PRK) to address residual myopia or myopic astigmatism. Setting: The study was conducted at Clínica Baviera – Aier Eye Hospital Group, Spain. Design: Retrospective analysis of cases. Methods: The study assessed uncorrected distance visual acuity, corrected distance visual acuity (CDVA), predictability, safety, efficacy, and patient satisfaction after implantation of the ICL and bioptics. The model implanted was V4c and EVO (Staar Surgical), with a correction of –18.00 D. Bioptics were performed at least 3 months after implantation, and patients were followed up for at least 3 months after LASIK or PRK. Results: The analysis included 125 eyes from 90 patients. Of these, 51.2% underwent LASIK and 48.8% PRK. Mean time from implantation to bioptics was 5.9 ± 9.4 months. Patients were followed up for a mean of 40.2 ± 37.9 months after bioptics. Median manifest refractive spherical equivalent was –2.89 D before bioptics and –0.49 D after. Median CDVA was 0.18 logMAR before bioptics and 0.17 after. The mean safety and efficacy indices were 2.22 ± 1.88 and 2.06 ± 1.85, respectively. Conclusion: Visual outcomes and safety indices following ICL implantation and subsequent LASIK or PRK in patients with extreme myopia are excellent.