title: Laser in situ keratomileusis for recurrent hyperopia following laser thermal keratoplasty.
abstract: 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.
authors.affiliation: Instituto Oftalmologico de Alicante, Department of Refractive Surgery, Miguel Hernandez University, Spain.
authors.forename: W
authors.initials: W
authors.lastname: Attia
authors.forename: J J
authors.initials: JJ
authors.lastname: Pérez-Santonja
authors.forename: J L
authors.initials: JL
authors.lastname: Alió
mesh_terms: 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