Lasik For Extreme Hyperopes With Reduction Of Corneal Prolateness To Control Induced Spherical Aberration

Purpose: To evaluate the visual outcomes of young extreme hyperopic patient’s LASIK, using customized centration and corneal aspherization to control the induced spherical aberration.

Setting: Hopital Fondation Adolphe de Rothschild

Methods: Prospective interventional study of consecutive extreme hyperopes (≥+6 D (from + 6 to +9D) of Spherical Equivalent SE) undergoing a LASIK with the WaveLight FS200 femtosecond and EX500 excimer laser platforms. An aspheric ablation profile (planned change in corneal asphericity ΔQ = +0.2) was delivered using the Custom-Q nomogram (Alcon Laboratories, Inc., Fort Worth, TX) on an optical zone of diameter ≥ 6.5mm centered near the corneal vertex. Uncorrected and best-corrected distance visual acuity (UDVA-BDVA), as well as changes in SE, corneal asphericity (ΔQ) and Higher order aberrations (HOAs), were analyzed preoperatively and on day1, months 1, 3, 6, and 12

Results: 63 eyes of 42 patients, (mean age of 33.2 ± 3.9 years), were included. Preoperatively and at 12 months postoperatively, the mean SE was 7.1 ± 2.1 D and +0.75 ± 0.7 D, respectively. 76% of eyes achieved 0 Log Mar or better UDVA at 12 months. One month after the surgery, there was a statistically significant induction of positive spherical aberration that decreased progressively and significantly at the last visit (Preop SA4 = 0.15 ± 0.19 µm, D1 SA4 = 0.39 ± 0.38 µm, M12 SA4 = 0.17 ± 0.29 µm, p=0.051). four eyes needed retreatment at 12 months

Conclusions: LASIK for extreme levels of hyperopia showed good outcomes. These are mainly due to an aspheric-customized ablation profile with a change of ΔQ = +0.2 in corneal asphericity.