Long-term evaluation of hyperopic laser in situ keratomileusis

Purpose: To evaluate the efficacy, safety, and predictability of hyperopic laser in situ keratomileusis (H-LASIK). Setting: Departments of Ophthalmology, Hadassah University, Hospital, Jerusalem, and Assaf Harofeh Medical Center, Zerifin, Israel. Methods: This prospective noncomparative case series studied the results of H-LASIK in the first 92 consecutive eyes of 50 patients with up to +10.25 diopters (D) of hyperopia. For analysis, the patients were divided into 3 groups based on preoperative hyperopia: low hyperopia (<+3.00 D), moderate hyperopia (greater than or equal to+3.00 to 6.00 D), and high hyperopia (greater than or equal to+6.00 D). Results. Forty-two patients, 77 eyes (83.7%), were followed for at least 12 months. At 12 months, the mean manifest spherical equivalent was +0.33 +/- 0.65 D (93.1% of eyes within +/-1.0 D of the intended correction) in the low myopia group, +0.21 +/- 0.60 D (92.3% within +/-1.0 D of the intended correction) in the moderate hyperopia group, and +1.62 +/- 1.50 D (36.4% within +/-1.0 D of the intended correction) in the high hyperopia group. The uncorrected visual acuity (UCVA) was 20/40 or better in all eyes (100%), 24 eyes (92.3%), and 13 eyes (59.1%) in the low, moderate, and high hyperopia groups, respectively. Comparing the UCVA at the last examination with the best corrected visual acuity (BCVA) before surgery in all patients showed that 59 eyes (76.6%) were within +/-1 line and 18 eyes (23.4%) were within +/-2 or more lines of the preoperative BCVA. Three eyes (3.9%) in the high hyperopia group lost 2 or more lines of BCVA. Three eyes (3.9%) had flap-related complications. Eight patients (15 eyes) with a follow-up less than 12 months did not have intraoperative or postoperative complications. Conclusion: Laser in situ keratomileusis was a safe, effective, and predictable procedure for hyperopia up to +6.0 D and less predictable for higher hyperopia. (C) 2003 ASCRS and ESCRS.