Laser in situ keratomileusis for hyperopia after thermal keratoplasty

The correction of hyperopia remains challenging because regression occurs often after treatment. The authors evaluated laser in situ keratomileusis (LASIK) using the Nidek EC-5000 scanning slit excimer laser to correct residual hyperopia after thermal keratoplasty.

Twelve eyes underwent hyperopic LASIK for residual hyperopia after thermal keratoplasty. All eyes were treated using the Nidek excimer laser and Chiron Automated Corneal Shaper. Hyperopic correction was done using a 5.5- to 7.5-mm ablation zone.

Mean preoperative cycloplegic spherical equivalent refraction was +3.31 D (range, +1.00 to +6.50 D). Mean preoperative astigmatism was -0.48 D (range, 0 to -2.00 D). Postoperatively, all eyes achieved a reduction in hyperopia. After 1 year of follow-up, the mean refraction was +0.88 D (range, 0 to +1.50 D). Mean postoperative astigmatism was -0.38 (range, 0 to -1.50 D). Two eyes experienced improvement in visual acuity and 3 eyes had reduced visual acuity, but no other vision-threatening complications were reported. The rate of regression was slow over 24 months. No morphological changes on the radial thermal scars were observed.

Hyperopic LASIK after thermal keratoplasty is safe and effective, and without vision-threatening complications.