Excimer laser correction of hyperopia, hyperopic and mixed astigmatism: past, present, and future

The broad acceptance of "spot scanning" or "flying spot" excimer lasers in the last decade has enabled the domination of corneal ablative laser surgery over other refractive surgical procedures for the correction of hyperopia, hyperopic and mixed astigmatism. This review outlines the most important reasons why the ablative laser correction of hyperopia, hyperopic and mixed astigmatism for many years lagged behind that of myopia. Most of today's scanning laser systems, used in the LASIK and PRK procedures, can safely and effectively perform low, moderate and high hyperopic and hyperopic astigmatic corrections. The introduction of these laser platforms has also significantly improved the long term refractive stability of hyperopic treatments. In the future, further improvements in femtosecond and nanosecond technology, eye-tracker systems, and the development of new customized algorithms, such as the ray-tracing method, could additionally increase the upper limit for the safe and predictable corneal ablative laser correction ofhyperopia, hyperopic and mixed astigmatism.