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Laser in situ keratomileusis for high hyperopia with corneal vertex centration and asymmetric offset

Laser in situ keratomileusis for high hyperopia with corneal vertex centration and asymmetric offset

Eur J Ophthalmol 2017; 27(2): 141 - 152

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5000835

Authors

Diego de Ortueta, Sam Arba-Mosquera

Abstract

Purpose

To investigate refractive outcomes and induction of corneal higher order aberrations (HOA) in eyes that underwent laser-assisted in situ keratomileusis (LASIK) for high hyperopia correction using an aberration neutral profile with corneal vertex centration and asymmetric offset.

Methods

A total of 24 consecutive patients (38 eyes) who underwent LASIK by one surgeon using AMARIS 750S excimer laser and a Carriazo-Pendular microkeratome for flap creation were retrospectively analyzed. Eyes targeted for plano and with correction in the maximum hyperopic meridian strictly higher than +4D were included in the retrospective analysis. Patients were reviewed at 1, 3, and 6 months postoperatively. Postoperative monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, and corneal wavefront aberrations were compared with respective preoperative metrics.

Results

Mean preoperative spherical equivalent and refractive astigmatism was +4.07 ± 0.90 D and 1.37 ± 1.26 D, respectively, reducing to +0.28 ± 0.58D (p<0.0001) and 0.49 ± 0.47 D (p = 0.0001) at the last postoperative visit. Six months postoperatively, 78% of eyes achieved a UDVA of 20/25 or better. No eye lost more than 2 Snellen lines of CDVA at any follow-up. There was a statistically significant induction of vertical trefoil (+0.104 ± 0.299 µm, p<0.05), vertical coma (-0.181 ± 0.463 µm, p<0.01), horizontal coma (+0.198 ± 0.663 µm, p<0.05), spherical aberration (-0.324 ± 0.281 µm, p<0.0001), secondary vertical trefoil (+0.018 ± 0.044 µm, p<0.01), and secondary horizontal coma (+0.026 ± 0.083 µm, p<0.05)

Conclusions

Laser-assisted in situ keratomileusis for high hyperopia using corneal vertex centration with asymmetric offset results in significant improvement in refraction and visual acuity although affected by significant induction of some higher order aberrations.

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: Samuel Arba-Mosquera is an employee at SCHWIND Eye-Tech-Solutions, Kleinostheim, Germany. He is the inventor of several patents owned by SCHWIND Eye-Tech-Solutions. Diego de Ortueta is a consultant at SCHWIND Eye-Tech-Solutions. He did not receive any reimbursements for his involvement in the study.

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Authors

Affiliations

  • Augenzentrum Recklinghausen, Recklinghausen - Germany
  • Research and Development, SCHWIND Eye-Tech-Solutions, Kleinostheim - Germany
  • Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid - Spain
  • Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo - Spain

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