title: Laser epithelial keratomileusis for the correction of hyperopia using a 7.0-mm optical zone with the Schwind ESIRIS laser.
abstract: OBJECTIVE
  To investigate the efficacy of laser epithelial keratomileusis (LASEK) for the correction of hyperopia using a 7.0-mm optical zone and a 9.0-mm total ablation zone diameter with the Schwind ESIRIS flying-spot laser.
  
  
  METHODS
  Forty-seven patients (70 eyes) were treated with a mean preoperative spherical equivalent refraction of +2.32 diopters (D) (range: 0 to +5.00 D). All eyes underwent LASEK using 15% alcohol with a 20-second application.
  
  
  RESULTS
  An intact epithelial flap was obtained in 66 (94%) eyes. In 70 eyes at 12 months, the mean spherical equivalent refraction was +0.09 D (range: -0.75 to +1.00 D) with all (100%) eyes within +/- 1.00 D of the intended correction and 60 (86%) eyes within +/- 0.50 D. In 40 eyes with 24-month follow-up, the refractive correction remained stable after 6 months. Hyperopic cylindrical corrections were attempted in 49 eyes (range: +0.25 to +5.00 D) with vector analysis demonstrating a mean 102% correction at 12 to 24 months. In 60 non-amblyopic eyes, uncorrected visual acuity was > or = 20/20 in 47 (78%) eyes. Thirty-three (47%) eyes gained 1 to 2 lines of Snellen decimal equivalent best spectacle-corrected visual acuity, 30 (43%) eyes showed no change, and 7 (10%) eyes lost 1 line. Eight (11%) eyes at 12 to 24 months had grade +/- 1 of paracentral corneal haze and 57 (81%) had no haze. At 12 months (n = 70), the safety index was 1.06 with an efficacy index of 0.95. Analysis of higher order wavefront aberrations showed no significant changes in root-mean-square values post-operatively, except for a significant reduction of fourth order spherical aberration (P < .05).
  
  
  CONCLUSIONS
  Laser epithelial keratomileusis for hyperopia up to +5.00 D using a 7.0-mm optical zone with the Schwind ESIRIS laser provides excellent refractive and visual outcomes with minimal complications. In eyes followed for 24 months, the refractive correction remained stable after 6 months.
authors: Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom. davidobrart@aol.com
authors: David P S
authors: DP
authors: O'Brart
authors: Faye
authors: F
authors: Mellington
authors: Sophie
authors: S
authors: Jones
authors: John
authors: J
authors: Marshall
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003318:Corneal Opacity / Q000209:etiology; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity