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Vision-Specific Quality of Life

Laser-Assisted in situ Keratomileusis Versus Overnight Contact Lens Wear

González-Pérez, Javier O.D., Ph.D., F.I.A.C.L.E.; Sánchez García, Ángel O.D., M.Sc.; Villa-Collar, César O.D., Ph.D., F.A.A.O.

doi: 10.1097/ICL.0000000000000538

Objectives: To compare the visual-related quality of life in myopic subjects with different refractive treatments such as continuous wear of silicone-hydrogel contact lenses (CL), corneal refractive therapy (CRT), and laser-assisted in situ keratomileusis (LASIK).

Methods: The National Eye Institute Refractive Error Quality of Life Instrument (NEI RQL-42) questionnaire was administered to 96 subjects with a mean age of 30.0±7.9 years. There were 72 myopic subjects with a mean spherical equivalent of −2.74±0.98 D (−5.50 to −1.25 D). Subjects were corrected with LASIK (n=24), Paragon CRT orthokeratology lenses (n=24), and lotrafilcon A silicone-hydrogel CL under continuous wear (n=24). The NEI RQL-42 survey was used to compare differences between groups as well as with an emmetropic group (n=24).

Results: After 1 year of treatment, significant differences were found among all groups in the subscales glare (P=0.017), symptoms (P=0.016), dependence on correction (P<0.001), and worry (P<0.001). The mean difference compared with emmetropes were −5.5% (P=0.063) for LASIK patients, −2.0% (P=0.212) for orthokeratology subjects, and +1.6% (P=0.934) for the silicone-hydrogel CL group.

Conclusions: Myopic subjects analyzed in this study reported better vision-related quality of life when they were corrected with continuous wear silicone-hydrogel lenses. The average score reached by CRT was similar to emmetropes, which showed the main disadvantage in worry subscale. The patients who underwent LASIK had the lowest valuation, highlighting the decreases in scores of diurnal fluctuations, glare, and especially in expectations and worry subscales, due to the first and second subscales, but especially to the false expectations created about treatment.

Ocular Surface and Contact Lens Research Laboratory (J.G.-P., Á.S.G.), Faculty of Optometry, University of Santiago de Compostela, Santiago de Compostela, Spain; and Optics and Optometry Department (C.V.-C.), Faculty of Health Sciences, Universidad Europea, Madrid, Spain.

Address correspondence to Javier González-Pérez, O.D., Ph.D., F.I.A.C.L.E., Lab. SOYLC—Applied Physics (Optometry), Faculty of Optometry, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain; e-mail:

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

Accepted June 11, 2018

© 2019 Contact Lens Association of Ophthalmologists, Inc.