Laser in situ keratomileusis for hyperopia resulted in less regression, minimal haze, and better predictability and stability than surface photorefractive keratectomy. Preoperative corneal radius appeared to be an important factor in eyes with high hyperopia.

Although myopic LASIK induced significant corneal aberrations, the level of partial compensation of corneal aberrations by internal structures remained unchanged. These results suggest that the previously described emmetropization that is effective during development may also be effective with acquired variations in corneal shape.

PURPOSE: To compare the refractive, visual acuity, topographic, and spherical aberration outcomes of LASIK using the Quest excimer laser platform with the optimized prolate ablation (OPA) profile (NIDEK Co Ltd) in one eye and conventional ablation profile in the fellow eye of the same patient. METHODS: Thirty-seven myopic patients underwent LASIK bilaterally, with one eye randomized to receive OPA ablation (−3.88±1.42 diopters [D], range: −1.53 to −7.50 D) and the fellow eye to receive conventional ablation (−3.89±1.37 D, range: −1.75 to −7.00 D). Independent and paired t tests were used for testing differences between groups at last postoperative follow-up (6 or 12 months). RESULTS: Postoperatively, 97% (32/33) of OPA eyes and 94% (31/33) of conventional eyes saw 20/20 or better without correction ( P >.05). No eyes lost 2 or more lines of distance corrected visual acuity. Manifest refraction spherical equivalent was −0.16 D in the OPA group and −0.05 D in the conventional group ( P >.05). Ocular spherical aberration was −0.003 μm in the OPA group and +0.102 μm in the conventional group ( P <.05). Corneal asphericity was statistically lower after OPA (0.07±0.26) compared to conventional ablation (0.30±0.26) ( P <.001). The mean programmed optical zone and achieved postoperative horizontal diameter of the effective optical zone were statistically significantly larger in the OPA group ( P <.05). CONCLUSIONS: Postoperative visual acuity and refractive outcomes were similar between groups. Laser in situ keratomileusis using the OPA profile for the correction of myopia induced significantly less corneal and ocular spherical aberration, resulted in normal postoperative asphericity in 94% of eyes, and larger horizontal diameter of the effective optical zone compared to the conventional profile.

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