Hybrid Myopia Correction: Icl In One Eye And Laser Vision Correction In The Fellow Eye – Patient Satisfaction And Visual Outcomes

To evaluate patient-reported outcomes and satisfaction in myopic patients with anisometropia treated using a hybrid approach: implantable collamer lens (ICL) implantation in one eye and laser vision correction (LVC) in the fellow eye, assessing its impact on visual function, patient experience, and perceived benefit.

King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.

Prospective study using retrospectively collected data from adult myopic patients undergoing hybrid correction between June 2014 and November 2022. The study included fifteen patients (30 eyes, ≥18 years) underwent ICL in one eye and LVC in the fellow eye. Exclusion criteria: pregnancy, age <18, keratoconus, prior keratoplasty, post-LASIK ectasia, amblyopia. Evaluations included UCVA, BCVA, refraction, and keratometry. Patient-reported outcomes were assessed ≥2 months postoperatively using the validated Arabic NEI RQL-42 questionnaire. Mann–Whitney U test used for statistical analysis, with significance at p<0.05.

Fifteen patients (30 eyes) included. Mean baseline anisometropia 5.57 ± 2.82 D. Preoperative SE: –9.82 ± 2.57 D (ICL) vs –4.07 ± 1.11 D (LVC, p<0.001). UCVA worse in ICL eyes (1.38 ± 0.22 vs 0.77 ± 0.30 logMAR, p<0.001); BCVA slightly lower (0.14 ± 0.16 vs 0.03 ± 0.07, p=0.021). Postoperatively, mean SE –0.46 D and UCVA 0.13 logMAR in both groups. NEI RQL-42 scores high for clarity, near/far vision, and satisfaction; lower for expectations and appearance.

Hybrid ICL–LVC correction for anisometropia achieves stable refractive outcomes, improved visual performance, and high patient-reported satisfaction. This approach is clinically effective, potentially cost-efficient, and offers a tailored solution for inter-eye refractive differences. Larger studies including baseline patient reported outcomes are warranted.