title: Five techniques for improving outcomes of hyperopic LASIK.
abstract: OBJECTIVE
  To determine whether five changes to our hyperopic LASIK protocol produced better outcomes.
  
  
  METHODS
  Five changes, both technical and surgical, were instituted for the treatment of hyperopia. These five changes were nomogram refinements accounting for accommodation, use of a 7.0-mm optical zone and a 9.5-mm transition zone, a targeted mean flap diameter of 10.5 mm, sequential interruption of the laser ablation, and cleaning of the interface. The study comprised 43 eyes undergoing LASIK for hyperopia or hyperopic astigmatism with a mean preoperative spherical equivalent refraction of +2.28 diopters (D), a mean sphere of +1.93 D (range: +4.25 to +0.25 D), and mean cylinder of +1.10 D (range: +4.50 to +0.25 D). The NIDEK CXII excimer laser was used for all treatments.
  
  
  RESULTS
  From 1 day to 3 months postoperatively, the mean hyperopic shift was <0.50 D. Postoperatively, the number of patients achieving a distance best spectacle-corrected visual acuity (BSCVA) of 20/20 gradually increased to 93% by 3 months. The number of eyes that achieved 20/15 increased by 11.7% compared to preoperatively. Eighty-eight percent of eyes maintained or gained lines of BSCVA. Four patients lost 1 line of BSCVA. One patient lost >1 line of vision due to visually significant microstriae.
  
  
  CONCLUSIONS
  The outcomes support the observation that five surgical and technical modifications to the hyperopic LASIK procedure result in excellent visual quality and refractive outcomes and a low rate of regression.
authors.affiliation: Instituto Zaldivar, Mendoza, Argentina. zaldivar@zaldivar.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Zaldivar
authors.forename: Susana
authors.initials: S
authors.lastname: Oscherow
authors.forename: Harkaran S
authors.initials: HS
authors.lastname: Bains
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008875:Middle Aged; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology