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Excimer Laser Versus Phakic Intraocular Lenses for Myopia and Astigmatism: A Meta-Analysis of Randomized Controlled Trials

Chen, Haiting, M.Med.; Liu, Yu, M.Med.; Niu, Guangzeng, M.Med.; Ma, Jingxue, D.Med.

Eye & Contact Lens: Science & Clinical Practice: May 2018 - Volume 44 - Issue 3 - p 137–143
doi: 10.1097/ICL.0000000000000327
Review Article

Objective: Meta-analysis of randomized controlled trials (RCTs) which compared excimer laser refractive surgery and phakic intraocular lenses (PIOLs) for the treatment of myopia and astigmatism.

Methods: An electronic literature search was performed using the PubMed, EBSCO, CNKI, and Cochrane Library database to identify prospective RCTs which compared excimer laser refractive surgery and PIOL with a follow-up time of at least 12 months. Efficacy, accuracy, safety outcomes, and complications were analyzed by standardized mean difference, risk ratio, and the pooled estimates according to a fixed effect model or random effect model.

Results: This review included 5 RCTs with a sum of 405 eyes. The range of myopia was 6.0 to 20.0 D with up to 4.0 D of astigmatism. The PIOL group was more likely to achieve a spherical equivalence within±1.0 D of target refraction at 12 months postoperatively (P=0.009), and was less likely to lose one or more lines of best spectacle corrected visual acuity than the LASER group (P=0.002). On the whole, there is no significant difference in efficacy and complications between the two kinds of surgeries.

Conclusions: This meta-analysis indicated that PIOLs were safer and more accurate within 12 months of follow-up compared with excimer laser surgical for refractive errors.

Department of Ophthalmology (C.H., L.Y., N.G.), Cangzhou Central Hospital, Cangzhou, China; and Department of Ophthalmology (C.H., J.M.), Second Hospital of Hebei Medical University, Shijiazhuang, China.

Address correspondence to Jingxue Ma, D.Med., Department of Ophthalmology, Second Hospital of Hebei Medical University, No. 215 Peace West Road, Qiaoxi District, Shijiazhuang, Hebei 050000, China; e-mail:

The authors have no funding or conflicts of interest to disclose.

Accepted August 08, 2016

© 2018 Contact Lens Association of Ophthalmologists, Inc.