Are Phakic IOLs Better than LASIK?

Although LASIK is the most popular refractive surgery, far more popular than the use of phakic IOLs, sometimes described as implantable contact lenses, there are some questions about whether it is the best refractive surgery for many different kinds of visual problems, including high myopia. Obviously, phakic IOLs offer many of the same benefits as LASIK: long-term vision correction, the freedom to see without using glasses or contacts, and the potential for even better vision correction than offered by traditional methods. Therefore, phakic IOLs are a natural competitor to LASIK surgery. But which one gives the best results?

Over the last few years, a number of studies have suggested that the crown for best results may go to phakic IOLs. At least two published studies and a conference lecture in the last few years suggest that phakic IOLs may give slightly better visual quality. One 2009 study looked at 46 eyes receiving STAAR's Implantable Collamer Lens (ICL) and 47 eyes that underwent custom LASIK for high myopia (<= -6 diopters), comparing pre-surgical and post-surgical higher-order-aberrations and contrast sensitivity. The study showed that phakic IOLs produced significantly fewer higher-order aberrations, and improved contrast sensitivity, whereas LASIK actually reduced contrast sensitivity. Another 2009 study looking at 45 patients (20 with two different phakic IOLs and 25 with LASIK) showed that one month after surgery, phakic IOL patients had recovered much more of their visual acuity than LASIK patients.

Additional support was given to phakic IOLs by a lecture given by Dr. Pablo Artal of the Optical Laboratory of the University of Murcia in Spain. Though his research was only suggestive and had not been formulated for publication, it suggested that LASIK may increase spherical aberrations as the degree of myopia increased, while phakic IOLs maintain or reduce spherical aberrations as myopia increases. However, the actual difference in visual outcomes was not as great as would be predicted by the measured refractive errors.

If you are looking for a long-term vision correction option for high myopia, you should talk to a local ophthalmologist today to learn more about your options and which one might be right for you.