Visual outcome in hypermetropic eye post-refractive surgery: retrospective cohort study

Correction of hypermetropia with laser refractive surgery is considered difficult and challenging compared to myopia, with few studies to make evidence-based decisions. This study assessed visual outcomes and complications in hypermetropic patients after refractive surgery.

This retrospective cohort study included 105 patients with hypermetropia who underwent either laser in situ keratomileusis or photo-refractive keratectomy at a specialized eye center in Jeddah, Kingdom of Saudi Arabia. Multiple preoperative factors were evaluated and compared to 1-month postoperative factors.

The patient cohort had a mean age of 38.1 ± 12.0 years, 67 (63.8%) of the patients were female, and laser in situ keratomileusis was performed on 84 (80%) cases. Preoperative central corneal thickness in the right and left eyes was 559 ± 37 and 560 ± 37 (P = 0.316), respectively. The preoperative and 1-month postoperative uncorrected visual acuity was statistically significantly improved in the right eye, from 0.62 ± 0.32 to 0.91 ± 0.27 (P = 0.025), and in the left eye, from 0.62 ± 0.31 to 0.89 ± 0.27 (P = 0.043). The preoperative and postoperative spherical equivalent showed a statistically significant reduction in the right eye from 2.47 ± 1.24 to 0.19 ± 0.96 (P = 0.001) and in the left eye from 2.64 ± 1.73 to -0.03 ± 1.26 (P = 0.001). A total of 13 (12.4%) patients had complications, with dry eyes (21.4%) being the most common manifestation. The complication rate was higher in female patients (16.4%) compared to male (5.3%, P = 0.048). Photo-refractive keratectomy had significantly higher complications rated (33.3%) compared to laser in situ keratomileusis (7.1%, P = 0.001).

Refractive surgery significantly improved visual outcomes in hypermetropic patients. Dry eye was the predominant complication, with higher rates found in females and patients who underwent photo-refractive keratectomy. Studies with extended follow-up are needed to evaluate the long-term complications and sustained efficacy of refractive surgery in hypermetropic patients.