Sinha Rajesh, Daga Juhi, Sahay Pranita, Gupta Vinay, Agarwal Tushar, Sharma Namrata, Maharana Prafulla K, Khokhar Sudarshan K, Titiyal Jeewan S
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Department of Ophthalmology, LVPEI, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2025 Jan 1;73(1):115-121. doi: 10.4103/IJO.IJO_908_24. Epub 2024 Sep 10.
To compare the visual outcomes of implantable Collamer lens (ICL) with small incision lenticule extraction (SMILE) in cases of moderate-high myopia.
A prospective comparative study was conducted on 60 eyes of 30 patients with moderate-high myopia (-3D to -8D with astigmatism ≤1 D) at a tertiary eye care center. Patients underwent either SMILE or ICL in both eyes and had a postoperative follow-up of 1 year.
The manifest refractive spherical equivalent was -5.22 ± 1.05 D and -5.4 ± 1.17 D in the SMILE and ICL groups, respectively ( P = 0.53). The mean sphere and cylinder were comparable between the groups. The mean uncorrected visual acuity improved from 1.18 ± 0.19 logMAR to 0.03 ± 0.07 logMAR in SMILE and 1.14 ± 0.25 logMAR to 0.011 ± 0.04 logMAR in the ICL group. The efficacy for SMILE was 83.3% and that for ICL was 93.3%. Safety and predictability (±0.5D) for both was 100%. A significant increase was observed in ocular aberration with a decrease in modular transfer function in the eyes that underwent SMILE, whereas no significant change in the eyes that underwent ICL. A significant difference was observed in all parameters of ocular aberration except corneal trefoil, corneal astigmatism, and PSF between the two groups at the final follow-up. The contrast sensitivity at final follow-up was higher in ICL cases when compared to SMILE. The quality of vision (QoV) score suggested a better QoV with ICL; however, the difference was not statistically significant.
Both SMILE and ICL are safe in patients with moderate-high myopia. The efficacy, contrast sensitivity, and postoperative ocular aberration profile are better in cases undergoing ICL.
比较中高度近视患者植入可植入式胶原晶状体（ICL）与小切口透镜切除术（SMILE）的视觉效果。
在一家三级眼科护理中心对30例中高度近视患者（-3D至-8D，散光≤1D）的60只眼进行了一项前瞻性对照研究。患者双眼均接受了SMILE或ICL手术，并进行了1年的术后随访。
SMILE组和ICL组的明显屈光球镜等效值分别为-5.22±1.05D和-5.4±1.17D（P = 0.53）。两组之间的平均球镜和柱镜相当。SMILE组的平均未矫正视力从1.18±0.19 logMAR提高到0.03±0.07 logMAR，ICL组从1.14±0.25 logMAR提高到0.011±0.04 logMAR。SMILE的有效率为83.3%，ICL的有效率为93.3%。两者的安全性和可预测性（±0.5D）均为100%。接受SMILE手术的眼睛中，随着调制传递函数的降低，眼像差显著增加，而接受ICL手术的眼睛则无显著变化。在最终随访时，两组之间除角膜三叶形、角膜散光和点扩散函数外的所有眼像差参数均存在显著差异。与SMILE相比，ICL病例在最终随访时的对比敏感度更高。视觉质量（QoV）评分表明ICL的QoV更好；然而，差异无统计学意义。
SMILE和ICL对中高度近视患者均安全。接受ICL手术的患者在疗效、对比敏感度和术后眼像差方面表现更好。
