The manifest average spherical equivalent refraction was -21.7 ± 5.8 D prior to surgery. This value became -6.0 ± 3.3 D after at least 10 years of follow-up. The regression was -6.1 ± 2.2 D in the period starting from the first month of the follow-up until the last control. The uncorrected visual acuity was 0.07 ± 0.1 at the last follow-up. The mean preoperative best-corrected visual acuity (BCVA) was 0.22 ± 0.12 and 0.30 ± 0.17 postoperatively (p < 0.001). Loss or gain of one line or more at the BCVA in the last control were 10.3 and 53.8 %, respectively. The safety and efficacy indexes are 1.56 ± 0.95 and 0.29 ± 0.4, respectively. No corneal ectasias were noted at follow-up. Although LASIK gives reliable results with high degrees of myopia, significant regression develops in the long term.
PURPOSE: To assess the efficacy and safety of holmium laser thermal keratoplasty (Ho:LTK) for hyperopia in eyes overcorrected after laser in situ keratomileusis (LASIK) for myopia.
METHODS: We performed a prospective evaluation of Ho:LTK in eyes with secondary hyperopia from +1.00 to +5.50 D after LASIK. Thirty-seven eyes of 23 patients received one concentric 8-spot application at the 6-mm-diameter zone. Mean patient age was 41.3 ± 13.0 years (range 20 to 68 yr). Mean corneal thickness was 455.86 ± 31.20 µm (range 373 to 506 µm).
RESULTS: Mean spherical equivalent refraction changed from +2.30 ± 1.08 D to +0.45 ± 1.00 D at 12 months after Ho:LTK. Thirty-one eyes (84%) were within ±1.00 D of emmetropia and 25 eyes (68%) were within ±0.50 D at 1 year. Mean change in refraction was 1.84 ± 0.92 D. No eye lost 2 lines of best spectacle-corrected visual acuity.
CONCLUSIONS: Ho:LTK is a suitable alternative for correcting secondary hyperopia resulting from LASIK for myopia. Parameter adjustments may be necessary for improving the results. [J Refract Surg 2004;20:253-257]
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