title: Sixteen-year follow-up of hyperopic laser in situ keratomileusis.
abstract: To assess the long-term efficacy and safety of hyperopic laser in situ keratomileusis (LASIK).
  
  
  
  Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
  
  
  
  Prospective cohort study.
  
  
  
  Hyperopic LASIK was performed using a mechanical microkeratome, an optical zone of 6.5 mm, and a blend zone of 1.5 mm. Simple hyperopia was treated.
  
  
  
  The mean patient age was 51.6 years (range 34 to 60 years). Preoperatively, the mean spherical equivalent (SE) was +3.74 diopters (D) (range +1.25 to +6.50 D). The mean attempted correction was +3.64 D (range +1.5 to +6.0 D). The mean follow-up was 16.5 years. The mean SE was +0.28 D (range -1.0 to +1.5 D) at 12 months, +0.84 D (range -0.75 to +3.35 D) at 5 years, and +1.74 D (range -0.75 to +4.13 D) at 16 years, representing an increase in hyperopia of +1.47 D ± 1.43 (SD) between 1 year and 16 years (P < .0001) and of +1.13 ± 0.8 D between 5 years and 16 years (P < .03). The uncorrected distance visual acuity improved at 16 years (P < .0001); corrected distance visual acuity (CDVA) was unchanged (P < .2). The efficacy index was 0.5 and the safety index, 1.09. One eye (3%) lost 2 lines of CDVA. Keratometry remained stable between 1 year and 16 years (P < 1.0). Four eyes (12%) had cataract surgery, and 2 (6%) had laser iridotomy. There was no ectasia.
  
  
  
  After hyperopic LASIK, an increase in hyperopia occurred between 1 and 5 years and 16 years. At 16 years, efficacy was limited but with no sight-threatening complications.
  
  
  
  Dr. Marshall was a consultant to Summit Technology, Inc. Dr. O'Brart holds a noncommercial research grant from Alcon Laboratories, Inc. None of the other authors has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Reena
authors.initials: R
authors.lastname: Dave
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. Electronic address: davidobrart@aol.com.
authors.forename: David P S
authors.initials: DP
authors.lastname: O'Brart
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Wagh
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Wei S
authors.initials: WS
authors.lastname: Lim
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Parul
authors.initials: P
authors.lastname: Patel
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lee
authors.affiliation: From the Keratoconus Research Institute, Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Marshall
mesh_terms: D000328:Adult; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular; D016896:Treatment Outcome; D006113:United Kingdom