Higher order aberrations and visual quality after refractive surgeries for myopia: a systematic review and network meta-analysis.
Tingting Chen, Furong Li, Dong Fang et al.
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In 30 seconds
This Bayesian network meta-analysis compared eight refractive surgery techniques for higher-order aberrations (HOAs) and visual quality in adults with myopia. It included 50 studies encompassing 5,141 eyes. Implantable collamer lens (ICL) surgery was associated with lower total HOAs than each of the seven other procedures; for example, the reported mean difference versus SMILE was 0.683 (95% CI 0.370-0.996). ICL also ranked highest for reducing total HOAs, spherical aberration, and coma, and was reported to outperform other interventions for spherical aberration and coma (P < 0.05).
Key findings
- Across 50 studies and 5,141 eyes, ICL showed lower total HOAs than SMILE (MD 0.683, 95% CI 0.370-0.996).
- ICL was reported to reduce spherical aberration and coma more effectively than the other interventions (P < 0.05).
- SUCRA rankings placed ICL highest for minimizing total HOAs, spherical aberration, and coma.
Why it matters
Higher-order aberrations can affect optical quality after refractive correction. This synthesis suggests that outcomes for these measures differ among surgical techniques, with ICL ranking favourably across several key aberration outcomes. Such comparative evidence can inform discussions of optical quality alongside refractive correction, while recognising that the analysis does not establish which procedure is best for every patient.
What to keep in mind
The findings synthesize studies comparing different procedures; the abstract does not report the certainty or directness of evidence for each comparison.