Predictability and stability of refraction with increasing optical zone diameter in hyperopic LASIK

Mostafa A El-Helw, Ahmed M Emarah

Cairo University, Cairo, Egypt

Objective: We undertook a prospective nonrandomized study to assess refractive outcome and patient satisfaction with hyperopic laser in situ keratomileusis (LASIK) using variable optical zone diameters in correction of hyperopia of more than 4.00 diopters.

Methods: Fourteen adults (comprising 28 hyperopic eyes) underwent hyperopic LASIK correction for hyperopia of more than 4.00 diopters. The sample was divided into two groups. Group 1 included the right eyes of the 14 patients who underwent hyperopic LASIK using a 6.5 mm optical zone diameter. Group 2 comprised the left eyes of the same patients with the only difference being that the optical zone diameter was 6.0 mm.

Results: The mean age of the patients was 36.42 ± 5.10 years. Group 1 eyes had a median (range) preoperative uncorrected visual acuity (UCVA) of 0.79 (0.52) and best-corrected visual acuity (BCVA) of 0.15 (0.08). Group 2 had a median preoperative UCVA of 0.79 (0.60) and BCVA of 0.15 (0.08). The median postoperative UCVA in Group 1 was 0.17 (0.21) and BCVA was 0.15 (0.13). In Group 2, the median postoperative UCVA was 0.30 (0.32) and BCVA was 0.15 (0.26). Group 1 had a median preoperative refraction of +5.37 (1.75) diopters and the median postoperative refraction at one week was −0.23 (1.25) diopters, at three months was +0.75 (0.75) diopters, and at six months was +0.75 (1.00) diopters. Group 2 had a median preoperative refraction of +5.00 (1.75) diopters, and the median postoperative refraction at one week was +0.13 (1.5) diopters, at three months was +1.00 (0.75) diopters and at six months +1.25 (1.25) diopters. The difference was statistically significant between groups 1 and 2. The difference within each group was also significant. Group 1 eyes were stabilizing after the three-month period in contrast with Group 2 in which the refractive changes continued throughout the follow-up period.

Conclusion: Larger optical zone diameter in correction of hyperopia of more than 4.00 diopters was more predictable, stable and safe.

Keywords: hyperopia, LASIK, optical zone, refraction