Long-term follow-up of hyperopic laser in situ keratomileusis correction using the Star S2 excimer laser

PURPOSE: To prospectively evaluate the safety, efficacy, predictability, and long-term stability of hyperopic laser in situ keratomileusis (LASIK) using the Star S2 excimer laser (Visx). SETTING: Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA. METHODS: This study evaluated 41 eyes of 27 patients who had LASIK for the correction of spherical hyperopia. Patients were divided into 3 groups based on preoperative cycloplegic refraction: low hyperopia (less than + 2.00 diopters [D]), medium hyperopia (+2.00 to +4.00 D), and high hyperopia (more than +4.00 D). RESULTS: In all eyes, the mean preoperative spherical equivalent (SE) was +2.53 D (range +0.75 to + 5.25 D) and the mean attempted SE was + 2.58 D (range +0.75 to +5.25 D). At the last visit (mean 5.29 years), the mean SE was +0.44 D +/- 0.69 (SD) in the low hyperopia group, +0.58 +/- 0.56 D in the medium hyperopia group, and +0.59 +/- 1.18 D in the high hyperopia group. The percentage of eyes within +/- 1.00 D of emmetropia was 82.4%, 75.0%, and 66.7%, respectively (68.9% overall). The uncorrected visual acuity was 20/40 or better in 100% of eyes in the low hyperopia group, 91.7% in the medium hyperopia group, and 66.7% in the high hyperopia group (87.8% overall). The hyperopic shift between 1 year and the last visit was +0.18 D, +0.30 D, and +0.55 D, respectively (+0.40 D overall; range -1.25 to +2.63 D). CONCLUSIONS: Hyperopic LASIK using the Star S2 excimer laser was safe, effective, and predictable for hyperopia up to +4.10 D (mean of high group). A mild regression of the refractive effect was seen over the 5-year follow-up.