Consultation Section: Refractive. Consecutive hyperopia after myopic laser in situ keratomileusis.

A 31-year-old woman was seen at our clinic with dissatisfying hyperopic error after a myopic laser treatment of her left eye in April 2018. The surgery took place 1 year previously. There were no abnormalities in her medical history.The preoperative corrected distance visual acuity (CDVA) in the left eye was 20/16 with -7.50 -0.50 × 75. The refraction in the right eye was -3.50 -1.25 × 90. The cycloplegic correction of the left eye preoperatively was -6.50 -0.50 × 68. A femtosecond-assisted laser in situ keratomileusis procedure was performed with an optical zone of 6.3 mm, an ablation zone of 7.97 mm, and a maximum ablation depth of 121 μm. The laser was set at a correction of -7.50 -0.5 × 75. The temperature and humidity during the laser treatment were 20 degrees and 47%, respectively. shows the excimer laser treatment data (AMARIS 750, SCHWIND eye-tech-solutions).At 1 week postoperatively the uncorrected distance visual acuity (UDVA) was 20/25, and at 1 month postoperatively the CDVA was 20/16 with +2.50. Slitlamp examination showed a clear cornea. No corneal topography was made at that timepoint. At referral 7 months later, the patient's UDVA was 20/100 and CDVA was 20/16 with +2.50 -1.25 × 140 in the left eye. The patient reports decreased vision since the treatment in 2018 and wants to see better without spectacles. shows the postoperative Scheimpflug topography of the left eye, flat keratometry (K1) 36.1 @ 178.4 and steep keratometry (K2) 36.6 @ 88.4. What do you believe could be the cause of this overcorrection? What is your advice in terms of correction of the refractive error for this patient?