Laser in situ keratomileusis for recurrent hyperopia following laser thermal keratoplasty

PURPOSE: Laser thermal keratoplasty (LTK) has its main indication in the co rrection of hyperopia, However, regression of refractive effect following L TK is a limitation. Laser in situ keratomileusis (LASIK) may provide a good alternative to correct residual refractive errors. METHODS: Fifty hyperopic eyes with varying amounts of regression after LTK underwent LASIK, The Chiron Automated Corneal Shaper microkeratome was used to make a flap of 160 mu m and laser ablation was performed with the Techn olas 217 Planoscan excimer laser. Postoperative follow-up was 6 months, RESULTS: Mean spherical equivalent refraction improved from +2.92 +/- 1.60 D to +0.36 +/- 1.48 D. Mean best spectacle-corrected visual acuity changed from 0.78 +/- 0.14 before LASIK to 0.76 +/- 0.16 D 6 months after LASIK, Me an uncorrected visual acuity changed from 0.37 +/- 0.16 to 0.66 +/- 0.24, F orty-two percent (21 eyes) were within +/-0.50 D of intended correction, 60 % (30 eyes) were within +/-1.00 D, and 76% (38 eyes) were within +/-2.00 D, After LASIK, confluent haze between previous LTK spots was observed in mos t eyes, as LASIK ablation took place at the sites of the LTK spots, CONCLUSIONS: LASIK after LTK is a good alternative for hyperopic regression . Predictability and efficacy are less than with primary LASIK for hyperopi a, but the procedure is equally safe.