ArticleBMC ophthalmology2026
Comparison of refractive outcomes and visual quality between femtosecond laser-assisted arcuate keratotomy and steep-axis meridian clear corneal incision combined with Implantable Collamer Lens (ICL) implantation for the correction of moderate-to-high myopia and low astigmatism.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study compared refractive outcomes and visual quality between femtosecond laser-assisted arcuate keratotomy (FSAK) and steep-axis meridian clear corneal incision (SCCI) combined with Implantable Collamer Lens (ICL) implantation for correcting moderate-to-high myopia and low astigmatism.
methodsThis prospective study included 28 eyes undergoing FSAK + ICL surgery and 31 undergoing SCCI + ICL surgery. The primary outcome was total corneal higher-order aberrations (HOAs) at 3 months postoperatively. HOA components, including spherical aberration, coma, and trefoil, were also analyzed as prespecified secondary visual-quality outcomes. Secondary outcomes included UDVA, CDVA, refraction (spherical equivalent and cylinder), astigmatism vector parameters, and corneal endothelial cell density, measured preoperatively and at 1 and 3 months postoperatively.
resultsData are presented as mean ± standard deviation unless otherwise stated. Postoperative spherical equivalent (SE), UDVA, or CDVA were comparable between groups. At 3 months, the safety index was 1.14 ± 0.12 and 1.04 ± 0.51 (P = 0.344), and the efficacy index was 1.13 ± 0.22 and 1.03 ± 0.23 (P = 0.118) for the FSAK and SCCI groups, respectively. All eyes (100%) in both groups achieved ± 1.00 D of the expected corrected SE. Residual astigmatism was − 0.48 ± 0.26 D in the FSAK group and − 0.41 ± 0.27 D in the SCCI group, (P > 0.05). Total HOAs at 3 months were lower in the FSAK group than in the SCCI group (P = 0.039), with lower spherical and trefoil aberrations in the FSAK group (P < 0.05). Corneal endothelial cell density did not change significantly in the FSAK group (P > 0.05) but decreased significantly in the SCCI group at 3 months (P < 0.01).
conclusionIn this short-term follow-up, FSAK and SCCI combined with ICL implantation demonstrated good safety, efficacy, and predictability for correcting moderate-to-high myopia with low astigmatism. FSAK showed better early stability, fewer higher-order aberrations (including spherical and trefoil components), and superior corneal endothelium protection compared to SCCI.
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