Night driving simulation in a randomized prospective comparison of Visian toric implantable collamer lens and conventional PRK for moderate to high myopic astigmatism

  • Published: J Refract Surg. 2010 May;26(5):321-6
  • Authors: Schallhorn S, Tanzer D, Sanders DR, Sanders M, Brown M, Kaupp SE.
  • Date Added: 30 Jan 2014
  • Last Update: 30 Jan 2014
  • Format: html


To compare changes in simulated night driving performance after lens implantation and or laser eye surgery to correct moderate to high myopic astigmatism.


A prospective, randomized study consisted of 43 eyes implanted with a particular type of contact lens and 45 eyes receiving conventional laser surgery for moderate to high myopia.

As a sub-study, 27 eyes of 14 lens patients and 41 eyes of 21 laser patients underwent a simulated night driving test. The detection and identification distances of road signs and hazards with the Night Driving Simulator were measured with and without a glare source before and 6 months after each procedure.

Key Findings:

  • No significant difference was noted in the pre- to post-operative Night Driving Simulator in detection distances with and without the glare source between the two groups.

  • The differences in identification distances without glare were significantly better for business and traffic road signs and pedestrian hazards in the lens group relative to the laser group whereas with glare, only the pedestrian hazards were significantly better.

  • A clinically relevant change of Night Driving Simulator performance (>0.5 seconds change in ability to identify tasks postoperatively) was significantly better in the lens group (with and without glare) for all identification tasks.

  • The lens performed better than conventional laser surgery in the pre- to postoperative Night Driving Simulator.