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ABSTRACT
PURPOSE: To evaluate excimer laser in situ keratomileusis (LASIK) for the correction of hyperopia.
METHODS: We reviewed retrospectively the medical records of 46 patients treated with LASIK for hyperopia. All patients had a complete ophthalmologic evaluation. The corneal bed was ablated using the Bausch & Lomb Chiron Keracor 117C excimer laser to create a paracentral annular ablation under a nasally hinged 160-µm corneal flap with the Chiron Automatic Corneal Shaper microkeratome. Follow-up was a minimum of 6 months.
RESULTS: Eighty eyes of 46 patients (23 males and 23 females) were included. Age ranged from 18 to 65 years (mean, 42 yr). The range of preoperative spherical equivalent refraction was +0.50 to +11.50 D (mean, +3.40 D). Mean postoperative spherical equivalent refraction at 6 months was +0.26 D. Six months after surgery, 35 eyes (44%) achieved uncorrected visual acuity of 20/20 or better and 78 eyes (97.5%) achieved 20/40 or better. Forty-six eyes (58%) had a postoperative spherical equivalent refraction within ±0.50 D of attempted correction, and 67 eyes (84%) were within ±1.00 D of attempted correction. When using the Bausch & Lomb Chiron Keracor 117C excimer laser to correct hyperopia, eyes with a spherical equivalent refraction less +2.00 D should be overcorrected by 25%, +2.00 to +4.00 D by 30%, and over +4.00 by 40%. The positive cylinder should, be overcorrected by 10%.
CONCLUSIONS: LASBS was safe and effective in the treatment of hyperopia from +0.50 to +11.50 D. Regression following LASIK for hyperopia remains a problem. A special nomogram was required to achieve results comparable with those for myopia. [J Refract Surg 2001;17:123-128]
The primary focus of refractive surgery has been the correction of myopia and astigmatism. Hyperopic and presbyopic refractions are common and recently there has been an increasing interest in the surgical correction of hyperopia.1 In the 19th century, electrocauterization was practiced to treat hyperopia, but the results were not promising.2 Techniques using peripheral hexagonal keratotomy had limited applicability because of reduced predictability and complications.36 Modification of non-intersecting spiral hexagonal incisions improved the refractive outcome for the treatment of primary hyperopia, but the need for consecutive operations remained high.78 Corneal lamellar surgery such as keratophakia, keratomileusis, and epikeratoplasty with a donor corneal lenticule were not popularized because of technical...