Phakic intraocular lenses (PIOLs) may be safer and more accurate than excimer laser refractive surgery to treat myopia and astigmatism, a recent study found. Researchers from China compared results from various randomized controlled trials that assessed the two treatment options for at least 12 months. They looked at efficacy, accuracy, safety outcomes and complications in 405 eyes from five different trials.

While the two options showed no significant differences in efficacy or complications, patients with PIOLs were more likely to achieve a spherical equivalence within ±1.0D of target refraction at 12 months after surgery. They were also less likely to lose one or more lines of best spectacle-corrected visual acuity than patients who underwent excimer laser refractive surgery. Beyond that, the study noted “PIOLs have a unique advantage in the treatment of astigmatism,” in that they showed the potential to “reduce the high-order difference and improve the contrast sensitivity.”

These results led the study to conclude that although both options “seem to be satisfactory refractive surgeries in correcting high myopia […] PIOLs are associated with better accuracy and safety.” They believe future studies should focus on longer-term data to confirm the safety of the two techniques.

Chen H, Liu Y, Niu G, Ma J. Excimer laser versus phakic intraocular lenses for myopia and astigmatism: a meta-analysis of randomized controlled trials. Eye Contact Lens. 2018;44(3):137-43.