LASER VISION CORRECTION FOR LOW HYPEROPIA - AN 18-MONTH ASSESSMENT OFSAFETY AND EFFICACY

Objective: This study aimed to assess the efficacy and safety of hyper opic photorefractive keratectomy (PRK) and to evaluate the effect of d egree of hyperopia, two epithelial removal methods, and various postop erative patient management techniques on clinical outcomes. Design: Pr ospective, nonrandomized, open-label clinical trial. Participants: A t otal of 38 patients with mean follow-up of 13.9 months (n = 65 eyes wi th hyperopia from +1.00 diopter [D] to +4.00 D) participated. Interven tion: Hyperopic PRK with the VISX STAR Excimer Laser System was perfor med. Main Outcome Measures: Spherical equivalent (SE) including vector analysis of SE; uncorrected visual acuity (UCVA); best-spectacle corr ected visual acuity (BSCVA); low-, medium- and high-contrast visual ac uities; topography; keratometry; pachymetry; and intraocular pressure, haze, and all other potential complications were measured. Results: A total of 80% of eyes were within +/-0.5 D and all but I eye (98%) wer e within +/-1.0 D of intended manifest SE at 1 year. There was no indu ced astigmatism at 1 year. At 12 months, 72% of eyes had UCVA of 20/25 or better and 70% had achieved preoperative BSCVA, with no eye seeing worse than 20/25, These results remained constant at 18 months. There was a tendency toward regression between months 1 and 6 with stabiliz ation of SEs between months 6 and 12. Thereafter, up to 18 months, the re was some regression with a mean of +0.31 D, but the number of patie nts was small. There was one mild decentration and Very slight decreas es in mean intraocular pressure and central corneal thickness. One pat ient had grade 1.0 haze develop in both eyes at 12 and 18 months; all other patients experienced trace or no haze. There were no significant complications. Conclusions: The results of this study support the hyp othesis that laser vision correction is safe and effective for treatin g low hyperopia. The predictability of the hyperopic laser vision corr ection procedure used in this study was very good, Other than the slow er recovery of BSCVA and UCVA seen with this procedure, as compared wi th myopic PRK, there were no significant complications. The trend towa rd some later regression needs to be further evaluated in a larger num ber of patients. Overall, patients were very pleased with the treatmen t, even in the first 6 months.