title: LASIK for Hyperopia Using an Aberration-Neutral Profile With an Asymmetric Offset Centration.
abstract: OBJECTIVE
  To investigate refractive outcomes and induction of corneal higher order aberrations (HOAs) in eyes with large pupil to corneal vertex offset that underwent LASIK for hyperopia using an aberration-neutral profile with corneal vertex centration and asymmetric offset.
  
  
  METHODS
  In this retrospective consecutive review, 26 patients (46 eyes) who underwent LASIK performed by one surgeon using the AMARIS 750S excimer laser platform and Carriazo-Pendular microkeratome (both from SCHWIND eye-tech-solutions, Kleinostheim, Germany) for flap creation were retrospectively analyzed. Only eyes targeted for plano and with a pupil to corneal vertex offset greater than 200 µm were included. The preoperative metrics were correlated with the outcomes at 3 and 6 months postoperatively.
  
  
  RESULTS
  The mean spherical equivalent was +3.43 ± 1.30 diopters (D) preoperatively and +0.21 ± 0.61 D at last postoperative visit (P < .0001). Mean refractive astigmatism was 1.09 ± 1.06 D preoperatively, and 0.39 ± 0.43 D at last postoperative visit. Postoperative uncorrected distance visual acuity of 20/25 or better was achieved in 74%, 65%, and 79% of eyes at 1, 3, and 6 months, respectively, compared to 85% corrected distance visual acuity of 20/25 or better preoperatively. Statistically significant correlation was observed between preoperative and postoperative aberration values for vertical trefoil (P < .0005), vertical coma (P < .0005), oblique tetrafoil (P < .0001), secondary cardinal astigmatism (P < .05), cardinal tetrafoil (P < .05), and secondary vertical trefoil (P < .05).
  
  
  CONCLUSIONS
  LASIK for high levels of hyperopia using corneal vertex centration with asymmetric offset was safe and predictable. Maintaining postoperative keratometry less than 49.00 D after hyperopic LASIK and centering on corneal vertex may reduce the induction of coma compared to other profiles or centration strategies.
authors: Samuel
authors: S
authors: Arba-Mosquera
authors: Diego
authors: D
authors: de Ortueta
mesh_terms: D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000503:physiopathology; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011680:Pupil / Q000502:physiology; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology