Three-year outcomes after high hyperopia correction using photorefractive keratectomy with a large ablation zone

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• High hyperopia presents a significant challenge for refractive surgery.
• Traditional photorefractive keratectomy (PRK) techniques have limitations in correcting higher degrees of hyperopia.
• Advanced excimer laser platforms offer new possibilities for treating complex refractive errors.

Purpose of the Study:

• To evaluate the refractive and visual outcomes of photorefractive keratectomy (PRK) for high hyperopia.
• To assess the efficacy, safety, and predictability of using an aberration-neutral profile and large ablation zone in PRK for hyperopia correction.
• To analyze changes in corneal aberrations and visual acuity over a three-year follow-up period.

Main Methods:

• A retrospective, consecutive observational case series involving 51 eyes of 34 patients with high hyperopia (+3.6 to +6.15 D).
• Alcohol-assisted PRK was performed using an Amaris 750S excimer laser with an aberration-neutral profile and a 10 mm total ablation zone.
• Outcomes including refractive error, visual acuity, predictability, and safety were evaluated at 1, 2, and 3 years postoperatively.

Main Results:

• Mean manifest refraction spherical equivalent (MRSE) was close to emmetropia at 3 years (+0.15±0.44 D).
• 78% of eyes achieved a correction within ±0.50 D of the target spherical equivalent.
• Corneal spherical aberrations showed a relatively low change, and visual acuity outcomes were favorable, with 27% gaining lines of vision.

Conclusions:

• PRK with an aberration-neutral profile and large ablation zone is effective and safe for correcting high hyperopia.
• The technique provides good predictability and satisfactory visual outcomes.
• Low changes in corneal aberrations and a stable refractive outcome were observed in the first three postoperative years.