Phakic IOL surpasses LASIK in stability and predictability at 10 years postop

J Refract Surg. 2011;27(4):270-286.

Despite endothelial cell loss, implantation of an angle-supported phakic IOL for high myopia proved more stable and predictable than LASIK at 10 years, a study found.

"Although many LASIK and [phakic] IOL procedures have been performed worldwide for the correction of high myopia, there is a lack of studies investigating and comparing the long-term outcomes of these two procedures," the study authors said.

The retrospective study included 126 eyes that underwent LASIK and 52 eyes implanted with the ZB5M single-piece PMMA angle-supported phakic IOL (Domilens). All patients had spherical equivalent of -10 D or greater. Mean patient age was 33.69 years in the LASIK group and 32.42 years in the phakic IOL group.

Mean preoperative spherical equivalent refraction was -14.33 D in the LASIK group and -14.84 D in the IOL group.

Study results at 10 years showed that mean spherical equivalent was -1.47 D in the LASIK group and -1.01 D in the IOL group. The difference was statistically insignificant.

At 2 years, 68% of eyes in the IOL group were within 1 D of emmetropia; 53% of eyes were within 1 D of emmetropia at 10 years. At 2 years, 67% of eyes in the LASIK group were within 1 D of emmetropia; 42% of eyes were within emmetropia at 10 years.

At 10 years, 43.5% of eyes in the LASIK group and 67.9% of eyes in the IOL group had uncorrected distance visual acuity of 20/40 or better. The difference was statistically significant (P = .02).

Mean endothelial cell loss at 10 years was 15.3% in the IOL group, the authors reported.