Excimer laser assisted in situ keratomileusis for hyperopia

Purpose: To evaluate hyperopic surgical correction with 6.0 mm optical zone hyperopic laser in situ ketatomileusis (LASIK) after various refractive procedures. Setting: Buzard Eye Institute, Las Vegas, Nevada, USA. Methods: This study followed 14 eyes of 14 patients who had hyperopic LASIK with a VISX Star laser. Mean follow-up was 8 months. The patients represented a variety of preoperative situations, including primary radial keratotomy (RK) (5 eyes), primary automated lamellar keratectomy (ALK) (2 eyes), primary LASIK (3 eyes), congenital hyperopia (1 eye), and combinations of ALK, RK, and LASIK. In all patients; a toroidal or "doughnut-shaped" ablation was constructed with the use of a 3.5 mm diameter soft contact lens as a blocking agent centrally with a 6.0 mm inside beam diameter. Results: Mean preoperative spherical equivalent was +1.33 diopters (D) +/- 0.5 (SD) (range +0.50 to +1.88 D). The mean spherical equivalent was -0.32 +/- 1.20 D (range -1.25 to +2.63 D) at 1 month postoperatively and -0.15 +/- 0.60 D (range -1.13 to +1.25 D) at the last follow-up, Uncorrected visual acuity of 20/40 was obtained by 13 eyes (93%). No eye lost 2 or more lines of best corrected visual acuity at last follow-up. Four eyes required a postoperative LASIK enhancement procedure to correct induced myopia. No significant complications were seen. Conclusion: Hyperopic LASIK with the technique used in this study appeared safe, predictable, and stable. it represents a simple way to add hyperopic correction to existing laser systems.