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Related Experiment Video

Updated: Jul 17, 2026

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile

Published on: September 20, 2024

Medical considerations before refractive surgery retreatment.

Karin E Thomas¹, David J Tanzer

¹Department of Ophthalmology, Naval Hospital, Camp Pendleton, California, USA. flykarin@aol.com

Journal of Cataract and Refractive Surgery

|February 6, 2007

Summary

A patient experienced a sudden vision change after refractive surgery, later diagnosed with diabetes. Managing underlying health conditions, like diabetes, is crucial for vision stability post-keratectomy.

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Last Updated: Jul 17, 2026

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile

Published on: September 20, 2024

Area of Science:

Ophthalmology
Endocrinology
Refractive Surgery

Background:

Photorefractive keratectomy (PRK) is a common procedure to correct myopia.
Late-onset hyperopic shift can occur after myopic PRK, necessitating careful patient evaluation.
Understanding potential systemic causes of refractive changes is vital for patient management.

Observation:

A healthy male patient developed a significant hyperopic shift two years after successful myopic PRK.
The refractive shift was sudden and coincided with a change in altitude.
The patient's uncorrected visual acuity was significantly impacted.

Findings:

A diagnosis of diabetes mellitus was established during the investigation of the refractive shift.
Initiation of insulin therapy led to a complete reversal of the hyperopic shift.
Uncorrected visual acuity returned to baseline 20/20 in both eyes after diabetes management.

Implications:

This case highlights the importance of considering systemic conditions, such as diabetes, in patients presenting with late-onset refractive errors after keratectomy.
Medical management of underlying systemic diseases can resolve refractive anomalies, potentially avoiding unnecessary surgical retreatment.
Ophthalmologists should maintain a broad differential diagnosis for refractive shifts, including metabolic and endocrine disorders.