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Hyperopic photorefractive keratectomy enhancement over laser in-situ keratomileusis flap

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Session Details

Session Title: Presented Poster Session: Keratorefractive Results I

Venue: Poster Village: Pod 2

First Author: : S.Awwad LEBANON

Co Author(s): :    M. Ahmad   M. Abdul Fattah           

Abstract Details


To evaluate the safety and efficacy of hyperopic photorefractive keratectomy (PRK) enhancement over laser in-situ keratomileusis (LASIK) flap for the treatment of residual hyperopia.


American University of Beirut Medical Center


A retrospective chart review of all hyperopic PRK over LASIK with at least 1 year of consistent follow up. 25 eyes of 15 patients, age 54.2 ± 6.2 years, with mean follow up of 3.1 ± 1.52 years, were included. Main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction spherical equivalence (MRSE), manifest refraction cylinder, uncorrected and corrected distance visual acuity (CDVA).


Preoperative mean MRSE was +1.73 ± 1.07 D, cycloplegic SE was +1.89±1.06 D, MR cylinder was -0.56±0.60 D. The attempted laser SE was 2.73±0.82 D. Postoperatively, for 1-month, 3-month, 6-month, 12-month, and last follow up, MRSE was -0.88±1.40, -0.78±1.16, -0.18±0.83, +0.02±0.82, +0.21±0.66 D, and +0.46±0.49 D, respectively. The MR cylinder was -0.30±0.49 D at 1-year, and -0.42±0.41 D at last follow up. UDVA of eyes treated for far vision was 0.06±0.1. One eye (4.17%) lost 1 line of CDVA. One eye developed +2 peripheral haze which was visually insignificant.


Hyperopic PRK over LASIK flap resulted in an expected transient myopic shift for the first 6 months postoperatively, but yielded good and stable refractive results past 1 year of follow up. It seems to be a safe and effective option for enhancing hyperopic eyes after a previous LASIK procedure, and might be a viable alternative to flap relifting, which harbors the potential risk of epithelial ingrowth especially relevant in hyperopic retreatments.

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