D K Williams1. 1. LaserVision Centres, London, England.
Abstract
OBJECTIVE: To assess the efficacy and safety of hyperopic laser vision correction using a refined ablation architecture and the VISX STAR Excimer Laser. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fifty-two eyes with hyperopia from +1 to +6 diopters (D) spherical equivalent (SE) with or without cylinder < or =1.5 D based on cycloplegic refraction. Hyperopia was primary or caused by prior overcorrection of myopia. INTERVENTION: Hyperopic laser vision correction using a 9 mm/5 mm ablation profile and a pulse rate of 10 Hz. We prescribed ciprofloxacin and fluorometholone four times a day for 1 week. MAIN OUTCOME MEASURES: SE; uncorrected visual acuity (UCVA); predictability within +/- 0.5 D, +/- 1.0 D, and +/- 2.0 D of target refraction (emmetropia); loss of best-corrected visual acuity (BCVA); haze, and all complications at 1, 3, 6, and 12 months. RESULTS: We treated 52 eyes (mean preoperative SE; +3.03 D). Forty-one eyes (78.8%) had primary hyperopia. At 3, 6, and 12 months, 66%, 67%, and 79% of all eyes had refraction within +/-0.5 D of emmetropia. At these same intervals, 83%, 88%, and 79% were within +/-1.0 D of emmetropia. At 12 months, all eyes were within +/-2.0 D. At 3 months, 85.4% of eyes had UCVA of 20/40 or better, with 95.3% achieving 20/40 or better at 6 months. At 1 year, all eyes (n = 19) had gained from 1 to 8 Snellen lines of UCVA, with most (n = 16) gaining between 3 and 7 lines. At 12 months, all eyes maintained preoperative BCVA or gained 1 to 4 lines. There was some early, transient haze < or = grade 1.5. There were no corneal infiltrates, decentered ablations, or infections. CONCLUSIONS: These data suggest that the 9 mm/5 mm hyperopic ablation profile of the VISX STAR can produce accurate corrections without significant, progressive regression. Refractive stability was achieved 3 months after surgery. We did not observe any differences in outcomes between eyes treated for primary hyperopia and eyes treated for prior myopic overcorrections. We believe the quicker ablation time (10 Hz pulse rate) helped patients maintain fixation and reduced the risk of decentration. There was a high degree of satisfaction among all patients, especially those with presbyopia.
OBJECTIVE: To assess the efficacy and safety of hyperopic laser vision correction using a refined ablation architecture and the VISX STAR Excimer Laser. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fifty-two eyes with hyperopia from +1 to +6 diopters (D) spherical equivalent (SE) with or without cylinder < or =1.5 D based on cycloplegic refraction. Hyperopia was primary or caused by prior overcorrection of myopia. INTERVENTION: Hyperopic laser vision correction using a 9 mm/5 mm ablation profile and a pulse rate of 10 Hz. We prescribed ciprofloxacin and fluorometholone four times a day for 1 week. MAIN OUTCOME MEASURES: SE; uncorrected visual acuity (UCVA); predictability within +/- 0.5 D, +/- 1.0 D, and +/- 2.0 D of target refraction (emmetropia); loss of best-corrected visual acuity (BCVA); haze, and all complications at 1, 3, 6, and 12 months. RESULTS: We treated 52 eyes (mean preoperative SE; +3.03 D). Forty-one eyes (78.8%) had primary hyperopia. At 3, 6, and 12 months, 66%, 67%, and 79% of all eyes had refraction within +/-0.5 D of emmetropia. At these same intervals, 83%, 88%, and 79% were within +/-1.0 D of emmetropia. At 12 months, all eyes were within +/-2.0 D. At 3 months, 85.4% of eyes had UCVA of 20/40 or better, with 95.3% achieving 20/40 or better at 6 months. At 1 year, all eyes (n = 19) had gained from 1 to 8 Snellen lines of UCVA, with most (n = 16) gaining between 3 and 7 lines. At 12 months, all eyes maintained preoperative BCVA or gained 1 to 4 lines. There was some early, transient haze < or = grade 1.5. There were no corneal infiltrates, decentered ablations, or infections. CONCLUSIONS: These data suggest that the 9 mm/5 mm hyperopic ablation profile of the VISX STAR can produce accurate corrections without significant, progressive regression. Refractive stability was achieved 3 months after surgery. We did not observe any differences in outcomes between eyes treated for primary hyperopia and eyes treated for prior myopic overcorrections. We believe the quicker ablation time (10 Hz pulse rate) helped patients maintain fixation and reduced the risk of decentration. There was a high degree of satisfaction among all patients, especially those with presbyopia.