EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY FOR HYPEROPIA

OBJECTIVE: Excimer laser photorefractive keratectomy (PRK) has been sh own to be an effective method in the treatment of refractive errors, e specially myopia. We evaluated prospectively the efficacy, predictabil ity, stability, and safety of excimer laser PRK in the treatment of hy peropia. METHODS: Thirty-four hyperopic eyes were treated with an Aesc ulap-Meditec (MEL 60) excimer laser The patients were divided into two groups. In the low-moderate hyperopia group, baseline spherical equiv alent refraction was between +1.50 and +6.00 diopters (D) (mean, +4.20 +/- 1.30 D)and in the high hyperopia group between +6.25 and +9.75 D (mean, +7.70 +/- 1.30 D). Follow-up visits occurred 1, 3, 6, and 12 mo nths after surgery. RESULTS: One-year results were available for a tot al 27 eyes (79%): 15 eyes with low to moderate hyperopia and 12 eyes w ith high hyperopia. One year after PRK in the low-moderate group, six eyes (40%) had a refractive error within +/- 1.00 D of emmetropia, but in the high hyperopia group only two eyes (17%) were within +/- 1.00 D of emmetropia; three eyes (20%) and one eye (8%) were within +/- 0.5 0 D, respectively. The stability of the refractive change was better i n the low to moderate hyperopia group; in the high hyperopia group the re was still some regression after 6 months. At 12 months, 10 eyes (67 %) in the low-moderate and one eye (8%) in the high hyperopia group ha d postoperative uncorrected visual acuity of 20/40 or better One eye i n the low-moderate hyperopia group saw 20/20 without correction. Only one eye lost two lines of spectacle-corrected visual acuity. Haze was more intense in the high hyperopia group, but it did not reduce visual acuity. No vision-threatening complications were observed. CONCLUSION S: When low to moderate hyperopia up to +6.00 D is treated, excimer la ser PRK with the Aesculap Meditec MEL60 laser is safe and moderately e ffective, and refraction stabilizes after 3 months in most eyes. Howev er, PRH is not sufficient to treat high hyperopia in an effective and predictable way.