Comparison of Subjective and Objective Visual Quality of Two Main Types of Refractive Surgeries in Early Postoperative Stage

Abstract Purpose: To explore subjective and objective visual quality of patients who underwent laser refractive surgery and ICL implantation in early postoperative stage after adjusting the imbalance of the baseline characteristics. Methods: This retrospective study included 58eyes with myopia and myopic astigmatism who underwent ICL V4c implantation or laser refractive surgery (including SMILE and FS-LASIK) in our hospital from July 2022 to December 2021. Objective visual quality mainly including higher-order aberrations (HOAs) were measured using an OPD-Scan III aberrometer (Nidek Co., Ltd., Gamagori, Japan) preoperatively and 1 week postoperatively. The subjective visual quality was obtained through the Quality of Vision (QoV) questionnaire. The propensity score inverse probability of treatment weighting (PS-IPTW) was used to balance the baseline characteristics. Results: After IPTW, the confounding factors with statistical significance between laser refractive surgery group and ICL implantation group. Before IPTW, the objective visual quality of laser refractive surgery was better than ICL implantation. However, after IPTW, only spherical aberration(p＝0.023) is statistically different between two groups. The patients who underwent laser refractive surgery reported better subjective visual quality in frequency(p＝0.020), severity(p＝0.043) and bothersome(p＝0.002). But two groups showed no significant difference after IPTW. Conclusion: The subjective and objective visual quality of patients who underwent laser refractive surgery and ICL implantation are relatively similar in early postoperative stage. The better subjective and objective visual quality in laser refractive surgery than ICL implantation could be influenced by imbalanced baseline characteristics.