Visual Outcomes After Ray-Tracing Guided Lasik And Icl (V4c) For High Myopia
Published 2026 - 44th Congress of the ESCRS
Reference: PP10.13 | Type: Free paper | DOI: 10.82333/5vqt-cp13
Authors: Dr Yanjia Li* 1 , Dr Bo Zhao 1 , Dr Bo Yuan 1 , Dr Xuefei Yang 1 , Dr Huiqin Zhang 1 , Dr Qian Zhang 1
1Refractive Surgery Department,Tianjin Aier Eye Hospital,Tianjin,China
Purpose
The aim of this study is to compare visual quality outcomes of implantable collamer lens (ICL) V4c and ray-tracing guided femtosecond laser-assisted in situ keratomileusis (RT-LASIK) in patients with high myopia(-6.00D< SEQ < -10.00D).
Setting
Implantable collamer lens (ICL) is safe, effective and longitudinally for the correction of high myopia. However, halos and glare were reported early postoperatively.
Ray-tracing guided LASIK is based on optical ray-tracing algorithm theory. There is an overall increase in ocular higher-order aberrations post-surgery, while spherical aberration is reduced. However, the current research primarily focuses on mild to moderate myopia, with limited data available on high myopia.
Methods
In this prospective comparative study, 60 eyes from 32 patients who underwent ICL and 60 eyes from 30 patients who underwent RT-LASIK were included. Preoperative characteristics, including uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), manifest refractive spherical equivalent (MRSE) and higher-order aberrations (HOAs) for a 4mm pupil (spherical aberration, coma, trefoil), were compared between the two surgical groups. Postoperative assessments at 3 months included measurements of UDVA,MRSE, HOAs, as well as the modulation transfer function (MTF) and point spread function (PSF) under a 4mm optical zone using OPD-Scan Ⅲ.
Results
The preoperative characteristics indicated no statistically significant differences (p>0.05). At the 3-month postoperative follow-up, there were no statistically significant differences in UDVA, MRSE, MTF, PSF and root mean square (RMS) value of total ocular aberrations between the RT-LASIK and ICL groups (p>0.05). However, analysis of HOAs revealed significant differences between the RT-LASIK and ICL groups (0.184±0.047 vs 0.118±0.038, p<0.05). Specifically, trefoil and vertical coma were significantly different (0.012±0.056 vs -0.045±0.044, p<0.05) (-0.095±0.078 vs -0.002±0.060, p<0.05), while spherical aberration showed no significant difference(0.002±0.054 vs 0.007±0.035, p=0.750).
Conclusions
In this study, RT-LASIK, a corneal laser procedure, achieved postoperative visual quality comparable to that of ICL. This is likely because RT-LASIK does not introduce spherical aberration. Thus, both RT-LASIK and ICL represent viable and effective surgical options for patients with high myopia.