BackgroundThis study sought to compare the visual quality between intraocular collamer lens (EVO-ICL) implantation and small-incision lenticule extraction (SMILE) and determine the appropriate surgical method to treat patients with high myopia (− 6.25 to − 10 D).MethodsA total of 48 eyes underwent EVO-ICL implantation and another 48 eyes underwent SMILE. The uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA) and equivalent spherical degree were compared across the SMILE (− 6.25 to − 10 D) and EVO-ICL (− 6.25 to − 10 D) implantation groups. Preoperative and postoperative visual quality parameters were compared between and within groups.ResultsThe OQAS II values (OV 100%) one week and one month after surgery and the modulation transfer function (MTF), OV 20% and OV 9% values one week after surgery in the SMILE group were lower than the respective preoperative values. The objective scatter index (OSI) value increased one week as well as one month after surgery compared with the preoperative values. The MTF cut-off value of the SMILE group was lower than that of the EVO-ICL implantation group three months after surgery.ConclusionsFor patients with high myopia, the postoperative visual quality of EVO- ICL implantation was slightly better than that of SMILE.

Background:This study aimed to investigate the clinical application of phakic toric intraocular collamer lens (TICL) implantation in treating ametropia following deep anterior lamellar keratoplasty (DALK) for patients with keratoconus, especially the effectiveness and safety of high astigmatism and indications of TICL implantation after corneal transplantation.Methods:Using the self-controlled case series observation approach, 9 patients with ametropia (9 eyes) who underwent DALK surgery for keratoconus 1.5 years ago with stitches removed 3 months ago were kept under observation from May 2013 to April 2014 in Ophthalmic Center of Nanjing Drum Tower Hospital affiliated to Nanjing Medical University. TICL implantation was performed in all patients. The uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were examined before surgery and 1 week, 6 months, 1 year, and 2 years after surgery. Corneal astigmatism, corneal thickness, anterior chamber depth, corneal endothelial cell density (ECD), and preoperative and postoperative intraocular pressures at different time points were measured. Intraoperative or postoperative complications of TICL implantation were observed, and the safety of the operation was evaluated.Results:The UCVA and BCVA in all operated eyes were better 6 months after surgery than before surgery. The spherical diopter and cylindrical diopter decreased to different degrees after surgery. Six months after surgery, the deviation of TICL axis in all operated eyes was less than 10 degrees, tending to be stable. No severe intraoperative or postoperative complication occurred.Conclusion:TICL implantation was an optional choice for ametropia correction after DALK surgery, especially in patients with high astigmatism.

The purpose of this retrospective study was to evaluate the visual quality, objective scattering index, aberration, etc after Implantable Collamer Lens with center hole (EVO-ICL) implantation to treat patients with hypermyopia (diopter > −10 D). A total of 30 eyes underwent EVO-ICL implantation. The uncorrected distance visual acuity (UDVA), best-corrected visual acuity (BCVA), equivalent spherical degree, aberration, visual quality parameters, and corneal endothelial cell density were compared preoperative and postoperative. Fill in the National Eye Institute Refractive Error Quality of Life Instrument-42 before and after surgery. The modulation transfer function (MTF), Optical Quality Analysis System (OQAS) II values (OV 100%, 20%, 9%), and Stahl ratio 1 and 3 months after surgery were higher than the respective preoperative values. The objective scatter index value increased 1 week after surgery, but decreased 1 and 3 months after surgery compared with the preoperative values. Total aberration (TA), total low-order aberration (tLOAs), and defocus decreased at 1 week and 3 months after EVO-ICL implantation. Total high-order aberration (tHOAs) and spherical aberration were significantly increased 1 week after surgery and decreased 3 months after surgery, and the difference was statistically significant. Astigmatism, coma, and clover were not significantly different in each time period. TA, tLOAs, tHOAs, defocus, and spherical aberration were higher at 1 week than 3 months after surgery. At 3 months after surgery, the scores of the patients’ NEI-RQL-42 scale were all improved except that the glare was lower than that before surgery. There was no significant difference in the density of corneal endothelial cells before and 3 months after surgery. For patients with hypermyopia, the postoperative subjective and objective visual quality of EVO-ICL implantation was better than preoperative.