Higher-order aberrations after iris-fixated foldable phakic intraocular lens implantation and wavefront-guided photorefractive keratectomy for the correction of myopia.

Purpose: To compare higher-order aberrations (HOAs) after foldable phakic intraocular lens (pIOL) implantation and wavefront-guided photorefractive keratectomy (PRK) for the correction of myopia.
Setting: Department of Ophthalmology, Medisch Centrum Haaglanden, Den Haag, The Netherlands.
Design: Comparative case series.
Methods: This retrospective comparative case series comprised eyes that had implantation of an Artiflex foldable pIOL or wavefront-guided PRK. Preoperative and postoperative refractive data, pupil diameter, endothelial cell density, and higher-order aberrations (HOAs) were measured and compared.
Results: The median follow-up was 13 months in the pIOL group and 10 months in the PRK group. The mean spherical equivalent (SE) in the pIOL group was -5.50 diopters (D) ± 1.05 (SD) (range -3.25 to -7.13 D) preoperatively and -0.26 ± 0.28 D (range -0.88 to 0.38 D) postoperatively and the mean in the PRK group, -5.72 ± 0.88 D (range -4.25 to -7.50 D) and -0.03 ± 0.42 D (range -0.75 to 1.00 D), respectively. The postoperative SE was within ±0.50 D in 86.4% of eyes and 85.2% of eyes, respectively. Postoperatively, the significant changes in the pIOL group and the PRK group, respectively, were as follows: total HOAs, 0.03 μm and 0.26 μm (P = .001); trefoil-y, 0.09 μm and -0.04 μm (P = .004); spherical aberration, -0.05 μm and 0.21 μm (P = .002).
Conclusions: Foldable pIOL implantation increased total HOAs and spherical aberration less than wavefront-guided PRK to correct low to moderate myopia, suggesting foldable pIOL implantation maintains the cornea's prolate shape better.
(Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)