Laser in situ keratomileusis for recurrent hyperopia following laser thermal keratoplasty.
OBJECTIVE
Laser thermal keratoplasty (LTK) has its main indication in the correction of hyperopia. However, regression of refractive effect following LTK is a limitation. Laser in situ keratomileusis (LASIK) may provide a good alternative to correct residual refractive errors.


METHODS
Fifty hyperopic eyes with varying amounts of regression after LTK underwent LASIK. The Chiron Automated Corneal Shaper microkeratome was used to make a flap of 160 microm and laser ablation was performed with the Technolas 217 Planoscan excimer laser. Postoperative follow-up was 6 months.


RESULTS
Mean spherical equivalent refraction improved from +2.92+/-1.60 D to +0.36+/-1.48 D. Mean best spectacle-corrected visual acuity changed from 0.78+/-0.14 before LASIK to 0.76+/-0.16 D 6 months after LASIK. Mean uncorrected visual acuity changed from 0.37+/-0.16 to 0.66+/-0.24. Forty-two percent (21 eyes) were within +/-0.50 D of intended correction, 60% (30 eyes) were within +/-1.00 D, and 76% (38 eyes) were within +/-2.00 D. After LASIK, confluent haze between previous LTK spots was observed in most eyes, as LASIK ablation took place at the sites of the LTK spots.


CONCLUSIONS
LASIK after LTK is a good alternative for hyperopic regression. Predictability and efficacy are less than with primary LASIK for hyperopia, but the procedure is equally safe.
Attia
W
W
Instituto Oftalmologico de Alicante, Department of Refractive Surgery, Miguel Hernandez University, Spain.
Pérez-Santonja
J J
JJ
Alió
J L
JL
D000328:Adult; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D017075:Laser Coagulation / Q000009:adverse effects*; D008875:Middle Aged; D012008:Recurrence; D012029:Refraction, Ocular; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity