LASIK for Hyperopia: A Report by the American Academy of Ophthalmology

To evaluate the effectiveness, predictability, safety, and stability of LASIK for hyperopia.

A literature search of the PubMed database was last conducted in August 2025. The search yielded 198 articles that were reviewed in abstract form, 88 of which were selected for full-text review. Twenty studies (containing a total of 25 different cohorts) met the criteria for inclusion in this assessment. The panel methodologists assigned a level of evidence rating to each study.

Two studies were rated level I, 6 studies were rated level II, and 12 studies were rated level III. Of the 18 cohorts for which effectiveness data were presented, at least 80% of eyes achieved an uncorrected distance visual acuity (UCDVA) of 20/40 or better, and in 16 of 18 cohorts, at least 50% of eyes achieved a UCDVA of 20/20 or better. Among the cohorts reporting predictability outcomes, 16 of 19 achieved more than 60% of eyes within ±0.50 diopter (D) of the intended correction. Likewise, 16 of 21 cohorts reported more than 90% of eyes within ±1.00 D of target, and all cohorts reached at least 80% within this range. Of the 23 cohorts for which safety data were presented, 19 cohorts contained no more than 3% and 15 cohorts contained no more than 1% of eyes losing 2 lines or more of Snellen corrected distance visual acuity (CDVA). The safety index (ratio of postoperative CDVA to preoperative CDVA) ranged from 0.97 to 1.05. In the cohorts in which refractive stability between 3 and 6 months was analyzed, the average spherical equivalent variation was 0.05 D (maximum, 0.3 D). Worse stability outcomes were associated with higher hyperopia treatments, slower pulse rates (< 500 Hz), older laser models, and smaller optical zones (≤ 6 mm).

LASIK for hyperopia performed using the current excimer laser models (characterized by faster pulse rates, larger optical zones, and updated ablation profiles) seems to have relatively high rates of effectiveness, predictability, safety, and stability.

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