Lasik as a Solution for High Hypermetropia

Abstract

Aim: To evaluate safety and efficacy of Laser in situ Keratomileusis (LASIK) procedure for the correction of high hypermetropia. Methods: Retrospective study of 160 patients (266 eyes) who underwent LASIK procedure for the correction of hypermetropia between +3.00 and +7.00 diopters(D) and cylinder up to 2.00D from January 2013 and August 2015. All ablations were performed with Wavelight Allegretto Eye-Q400Hzexcimer laser (Alcon, Forth Worth, TX, USA) with aberration free module and were centered on a corneal vertex. All flaps were made with Moria M2 (Moria, Antony, France) mechanical microkeratome (90μm head). Preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA, CDVA), spherical equivalent (SE) and a berrometry for 5mm pupil were measured. Measurements were taken at 1 week, 1,3,6 and 12 months after the surgery. Wilcoxon Signed Ranks Test was used for statistical analysis. Results: Postoperative UDVA was lower than preoperative CDVA at 1 week( p =0.001), at 1 month there was no difference ( p =0.099), and at 3,6 and 12 months UDVA was better ( p <0.0001). Preoperative SE was 4.69±1.20D (+3.75 to +7.50D). At 1 week SE was 0.03±0.67D (-0.50 to +0.63D), while at 1 year regressed to 0.58±0.56D (+0.25 to +0.88D). Sphere shifted from negative values targeted in treatment planning to compensate for regression to positive values. There was significant difference in SE at every time point ( p <0.0005). There was a significant increase in coma ( p <0.0001), trefoil ( p <0.0001, p =0.0006) and spherical aberration ( p =0.022, p =0.0052) at 1 week and 1 month postoperatively, without change throughout the rest of follow up. Conclusion: LASIK for high hypermetropia showed satisfactory results in postoperative refraction with reasonable regression without significant loss of lines of visual acuity. However, more test are necessary to asses optical quality.

Comparison of Visual Outcome After Hyperopic LASIK Using a Wavefront-Optimized Platform Versus Other Excimer Lasers in the Past Two Decades

“…Advancements in refractive surgery have made various lasers safer and more effective for the treatment of hyperopia [3][4][5][6][7]. Excimer lasers allow for a larger optical zone of ablation, more rapid ablation rates, and faster eye scanners.…”

Long-term results of hyperopic ablations using alcohol-assisted PRK and FS-LASIK: comparative study

“…The correlation between attempted correction and achieved spherical equivalence was moderately high in both groups, consistent with previous studies evaluating hyperopic laser treatments, but inferior to published results of myopic treatments. 14,[24][25][26][27][28] Although there was no statistically significant difference in SEDT between the PRK and FS-LASIK groups at 3 years postoperatively, the SEDT of PRK eyes was more spread out across a greater range than FS-LASIK eyes (Figure 1B). This variability is likely due to epithelial remodeling, which might be more predictable in LASIK than in PRK.…”

Choosing the right surgical treatment for hyperopia

“…Laser refractive surgery techniques are based on modifying the corneal curvature with the excimer laser (i.e. FS-LASIK, LASIK, LASEK, PRK) [5][6][7][8] or recently also with the femtosecond laser (hyperopic SMILE) [9][10][11]. These procedures flatten the paracentral cornea in order to steepen the its central area.…”