Holmium:YAG laser thermokeratoplasty (LTK), a procedure using a solid-
state infrared laser to treat hyperopia, was performed on 10 patients
in phase I and 16 patients in phase II-in a total of 29 eyes at the Hu
nkeler Eye Clinic. Phase II was redesigned after phase I results showe
d undercorrection and regression. The follow-up period ranged from 1 t
o 24 months (mean 10.9 months). A total of 79% of phase II patients we
re within +/- 1.00 D of intended correction at the 6-month visit. Look
ing at both phases together, no patients had J2 or better near vision
preoperatively, but 75% had J2 or better at the 6-month visit. A total
of 43% of eyes in phase II lost 1 line and 7% lost two lines of best
spectacle corrected visual acuity due to induction of irregular astigm
atism. The surgical challenges are to insure appropriate centration of
the procedure about the optical axis. Concerns about regression and s
tability will be defined as these patients are followed through their
2-year visits.