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Noncontact thermokeratoplasty to correct hyperopia induced by laser in situ keratomileusis
M M Ismail1, J L Alió, J J Pérez-Santonja
1Department of Ophthalmology, University of Alicante (Ismail Alió), Spain.
Purpose:
To evaluate the efficacy and safety of noncontact holmium:YAG (Ho:YAG) laser thermokeratoplasty (LTK) for treating hyperopia induced by laser in situ keratomileusis (LASIK).
Setting:
Department of Ophthalmology, University of Alicante, Instituto Oftalmológico de Alicante, Alicante, Spain, and the University of Al-Azhar, Cairo, Egypt.
Methods:
Noncontact LTK was applied to 13 eyes (11 patients) with significant hyperopia after LASIK using a Ho:YAG laser (model gLase 210, Sunrise Technologies). Mean spherical equivalent before LTK was +4.60 diopters (D) +/- 1.40 (SD) (range +2.50 to +7.25 D). The results were evaluated 18 months after the LTK surgery.
Results:
A significant myopic shift developed in all eyes that gradually receded to emmetropia 6 to 8 weeks after LTK. After 12 months, refraction was relatively stable. At 18 months, there was a statistically significant difference between the mean uncorrected visual acuity (UCVA) before LTK (0.19 +/- 0.09) and mean postoperative UCVA (0.61 +/- 0.22) (P < .005). At the end of the study, there was a mean increase of 4.10 +/- 1.12 D in central keratometric power. Total regression did not occur in any eye.
Conclusion:
Noncontact Ho:YAG LTK was safe and effective in correcting LASIK-induced hyperopia. The cutting of Bowman's layer and a thinner corneal center may contribute to the stability of LTK in such cases.