Hyperopic And Hyperopic-Astigmatic Fs-Lasik Using 2 Different Excimer Lasers

To evaluate visual and refractive outcomes of a novel excimer laser (Teneo Model II, Bausch&LombTechnolas, Munich, Germany) and to compare these to our prior hyperopic laser corrections with its predecessor, the Technolas 217z100 (Bausch & Lomb Technolas).

Center for Refractive Surgery, Eye Center at St. Francis Hospital Muenster, Germany

Retrospective case series of consecutive fs-LASIK surgeries in eyes with hyperopia and hyperopic astigmatic refraction. Same surgeon performed fs-LASIK with the VISUMAX 500kHz femtosecond laser platform (Carl Zeiss Meditec, Oberkochen, Germany) and both excimer lasers. All eyes had a cycloplegic refraction performed. Inclusion criteria: attempted hyperopic correction up to 5.5D sphere and astigmatism up to 5.75D, minimal epithelial thickness >45 µm, expected postoperative steepest keratometry <= 51.0D.  A minimum optical zone of 6 mm was used. CDVA was >0.63 (decimal scale). Outcome analysis: uncorrected distance visual acuity (UDVA), efficacy index (UDVA postop/CDVA preop), CDVA, and subjective refraction.

At 3 months, 216 eyes treated with plano target using Teneo II and 78 eyes using 217z100 were evaluated. Mean spherical equivalent refraction using Teneo II was +0.27 +/-0.44D (range: -1 to +1.75D), [Technolas 217z100, -0.14 +/-0.43D (range: -1.0 to +1.38D)]. Mean cylinder was -0.35 +/- 0.34D (range: 0 to -1.5D), [-0.4 +/-0.33D (range: 0 to -1.25D]. Mean uncorrected distance visual acuity (UDVA) was 1.22 [1.0]. Mean efficacy index was 0.89 [0.78]. Mean safety index was 0.99 [0.97]. Postoperative cylinder was £ 0.5 D in 81% [79%] of eyes and £1 D in 98% [96%] of eyes.

Using modern femtosecond and excimer-lasers visual and refractive outcomes of hyperopic LASIK with a large optical zone were excellent at 3 months. The Teneo II yielded better results than its predecessor.