Femtosecond Laser-Assisted In Situ Keratomileusis for the Treatment of Moderate to High Hyperopia.

Abstract

Report modern outcomes of femto-LASIK for the correction of moderate-to-high hyperopia (≥3.50 and ≤6.50D), excluding low or very high hyperopia. Vissum, Alicante, Spain. Monocentric retrospective case series study. Visumax-500kHz femtosecond-laser, and Amaris-750 excimer-laser were used. Eyes with at least 6-months of follow-up were included. 36-month data was collected when available. Primary outcome measure was short term efficacy and safety. Secondary outcome measure was long term stability. Six-month data of 92 eyes was collected (68 eyes at 36 months). Mean age was 34.6±10.4 years. Mean treated sphere was 4.69±0.87. Efficacy index was 0.91 and 0.90 at 6 and 36 months respectively. Safety index was 1.00. UDVA was 20/20 or better in 72%, postop spherical equivalent within 0.5D in 80% (93% within 1D), and loss of one line of CDVA occurred in 13% (2 or more lines in 0%). Gain of 1 or more CDVA lines occurred in 17%. A slight but significant regression was observed at 36 months. Postoperatively, 21.73% required flap lift for laser enhancement, and 11.95% an orthoptic visual rehabilitation due to accommodative disorders. Modern LASIK provides good efficacy and safety levels for the management of moderate to high hyperopia (up to +6.5D), with levels close to those previously reported with refractive lens exchange for young hyperopia patients without presbyopia, where we defend the maintenance of LASIK as first line therapy. Risk of requiring a refractive enhancement or an orthoptic visual rehabilitation remains relevant and needs to be discussed with patients preoperatively.