title: Femtosecond-assisted laser in situ keratomileusis for consecutive hyperopia after radial keratotomy.
abstract: OBJECTIVE
  To evaluate femtosecond-assisted laser in situ keratomileusis (LASIK) for the treatment of hyperopic shift after radial keratotomy (RK).
  
  
  METHODS
  Private practice, Siena, Italy.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Eyes with a spherical equivalent (SE) of +1.0 diopters (D) to +4.0 D after RK with 6 or 8 incisions had LASIK. The flap (nominal thickness 130 μm) was created with a femtosecond laser (LDV Z2); the refractive ablation was performed with an excimer laser (217P). The flap was dissected in a centrifugal fashion along previous RK cuts.
  
  
  RESULTS
  Eighteen eyes of 10 patients were treated. Preoperatively, the mean defocus equivalent was 3.13 diopters (D) ± 0.71 (SD); the corrected distance visual acuity (CDVA) was 0.09 ± 0.06 logMAR. At 9 months, the mean defocus equivalent was 0.51 ± 0.47 D (P < .05), with 13 eyes (72%) having 0.50 D or less of defocus equivalent and 16 eyes (89%) having 1.0 D or less of defocus equivalent. The mean CDVA was 0.04 ± 0.06 logMAR (P < .05). No lines of logMAR CDVA were lost. The mean uncorrected distance visual acuity was 0.11 ± 0.10 logMAR. The safety index was 1.11; the efficacy index was 0.97. No retreatments were performed. Flap complications were limited to an RK incision opening larger than 2 mm in 3 eyes and 1 case of a small, self-limiting epithelial ingrowth.
  
  
  CONCLUSIONS
  Laser in situ keratomileusis with a low-energy femtosecond laser was a safe and effective approach to treat post-RK hyperopia, causing no relevant inflammation.
  
  
  BACKGROUND
  Neither author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Siena Eye Laser (Leccisotti, Fields), Poggibonsi, Siena, Italy; the School of Biomedical Sciences (Leccisotti), University of Ulster, Coleraine, United Kingdom. Electronic address: leccisotti@libero.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Leccisotti
authors.affiliation: From the Siena Eye Laser (Leccisotti, Fields), Poggibonsi, Siena, Italy; the School of Biomedical Sciences (Leccisotti), University of Ulster, Coleraine, United Kingdom.
authors.forename: Stefania V
authors.initials: SV
authors.lastname: Fields
mesh_terms: D000328:Adult; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000601:surgery; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D007646:Keratotomy, Radial / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology