Results of photorefractive keratectomy for hyperopia using the VISX star excimer laser system

To evaluate safety, efficacy, and predictability of photorefractive keratectomy (PRK) for hyperopic astigmatism of +1.75 to 00 D manifest refractive sphere and up to -2.50 D manifest refractive astigmatism using the VISX Star excimer laser system, version 2.5 software.

Treatment was performed on 32 eyes of 21 patients. Eighteen of 21 patients were 45 years of age or older. Manifest and cycloplegic refraction together with Pelli-Robson contrast sensitivity assessment was performed prior to surgery and 1, 3, 6, 12, and 24 months after treatment.

Twenty-seven of 32 surgical procedures were reviewed 1 year after treatment (84%). Corneal epithelial healing was complete between day 4 and 10. Twelve months after treatment, 25 of 27 eyes (93%) achieved 20/40 or better uncorrected visual acuity and 19 eyes (70%) achieved 20/20. No patient lost two or more lines of Snellen visual acuity assessed 6 months and later after treatment. The mean spherical equivalent refraction was reduced from +2.90 at baseline to +0.10 D at 1 year and +0.40 D at 2 years; 65% of eyes had a refraction within +/- 0.50 D. Four patients had further treatment by laser in situ keratomileusis for undercorrection in three eyes and overcorrection in one eye. Pelli-Robson contrast acuity was significantly reduced 12 months after treatment from a mean 1.72 before to 1.66 after PRK (P = .02, t-test).

PRK for hyperopia using the VISX Star excimer laser system was effective in the treatment of hyperopic astigmatism. Although no patient lost two or more lines of high contrast best spectacle-corrected Snellen visual acuity 1 year after treatment, there was a significant decrease in Pelli-Robson contrast acuity.