Hyperopic laser-assisted in situ keratomileusis for radial keratotomy-induced hyperopia

Purpose: To evaluate hyperopic laser in situ keratomileusis (H-LASIK) for radial keratotomy (RK)-induced hyperopia. Design: Noncomparative interventional retrospective nonconsecutive case series. Participants: Sixty-nine eyes of 47 patients who had undergone RK and were seen with induced hyperopia. Methods: H-LASIK was performed with an excimer laser. Main Outcome Measures: The mean refractive error, in spherical equivalents (SE), uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) before and after H-LASIK are reported. Safety was analyzed using a mean follow-up time of 6.6 +/- 3.24 months. Results: Preoperative mean SE was +3.4 +/- 1.6 diopters (D). Postoperative mean SE was -0.32 +/- 1.2 D. A high percentage of eyes (79.7%; n = 55) were between +/-1.0 D of emmetropia and 88% within +/- 2.0 D. Preoperative BSCVA was 20/20 in 53.6% of eyes (n = 37) and 20/40 or better in 100% (n = 69). Postoperative BSCVA was 20/20 in 55% of eyes (n = 38) and 20/40 or better in 95.6% (n = 66) of eyes. Preoperative UCVA was less than or equal to20/50 in 52 cases (75.4%). Postoperative UCVA was 20/20 in 13 cases (18.8%) and 20/40 in 45 cases (65.2%). Four eyes lost 2 Snellen lines because of epithelial ingrowth in the interface (n = 3) and diffuse lamellar keratitis (Sands of the Sahara syndrome; n = 2). One of the eyes with Sahara syndrome also had epithelial ingrowth and flap necrosis. Thirteen eyes lost 1 Snellen line, and 50 eyes maintained or gained Snellen lines. The only intraoperative complication was incision opening (n = 8) while the flap was lifted; there were no further complications. These patients did not lose any Snellen lines of their BSCVA. Conclusions: H-LASIK can be used successfully to correct RK-induced hyperopia. Ophthalmology 2002; 109:602-605 (C) 2002 by the American Academy of Ophthalmology.