High hyperopic LASIK with reduction of corneal prolateness to control-induced spherical aberration.

PURPOSE: To evaluate visual outcomes of high hyperopic laser in situ keratomileusis (LASIK), using corneal aspherization to control the induced spherical aberration.

SETTING

Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.

DESIGN

Prospective interventional case series.

METHODS

Prospective interventional study of consecutive high hyperopes (≥+3 diopters [D] of spherical equivalent [SE]) undergoing LASIK with the WaveLight FS200 femtosecond and EX500 excimer laser platform. An aspheric ablation profile (planned change in corneal asphericity ΔQ = +0.2) was delivered using the Custom-Q nomogram on an optical zone of ≥6.5 mm centered near the corneal vertex. Uncorrected corrected distance visual acuity (UDVA) and corrected distance visual acuity, as well as changes in SE, corneal asphericity (ΔQ), and higher-order aberrations, were analyzed preoperatively and on day 1, 1, 3, 6, and 12 months.

RESULTS

117 eyes of 63 patients (mean age of 30.1 ± 5.6 years) were included. Preoperatively and at 12 months postoperatively, the mean SE was 5.1 ± 1.1 D and 0.00 ± 0.7 D, respectively. 88% of eyes achieved 0 logMAR or better UDVA at 12 months. 1 month postoperatively, there was a statistically significant induction of positive spherical aberration decreasing progressively and significantly until the last visit (preop SA4 = 0.09 ± 0.11 μm, day 1 SA4 = 0.30 ± 0.32 μm, 12 months SA4 = 0.08 ± 0.21 μm, P = .056). 2 eyes needed enhancement at 12 months.

CONCLUSIONS

LASIK for high levels of hyperopia showed good outcomes mainly due to aspheric-customized ablation profile with a change of ΔQ = +0.2 in corneal asphericity.