Researchers recently found that while both implantable collamer lens (ICL) V4c and small incision lenticule extraction (SMILE) provided efficacy, safety, predictability and satisfaction in correcting high myopia, SMILE may be associated with more undesirable postoperative visual outcomes.

This prospective analysis included 94 eyes of 57 patients (eight males) in the ICL V4c group (-8.07±1.03D) and 103 eyes of 57 patients (13 males) in the SMILE group (-7.85±0.78D). A team recorded refractive parameters and wavefront aberrations preoperatively and six months postoperatively, scored subjective visual quality with the Quality of Vision questionnaire and evaluated operation satisfaction six months postoperatively.

At follow-up, the team reported that both procedures had similar efficacy and safety. They observed a significant increase in total higher‐order aberrations in both groups, but to a lesser degree in the ICL group. They noted that, in this group, trefoil significantly increased; in the SMILE group, coma, trefoil and spherical aberration significantly increased. They added that glare, haloes and blurred vision had the highest incidences after both types of surgery, but postoperative haloes were significantly more common following ICL.

The study authors concluded that 96.1% of ICL-treated and 94.9% of SMILE-treated patients were satisfied with their visual outcomes.

Wei R, Li M, Zhang H, et al. Comparison of objective and subjective visual quality early after implantable collamer lens V4c (ICL V4c) and small incision lenticule extraction (SMILE) for high myopia correction. Acta Ophthalmologica. May 18, 2020. [Epub ahead of print].