Comparison Of Visual Outcomes Of Two Different Like Procedures In The Correction Of Moderate To High Hyperopia

To evaluate and compare the visual outcomes of two different lenticule intrastromal keratoplasty (LIKE) procedures in the correction of moderate to high hyperopia.

In this prospective study, totally 20 subjects (20 eyes) who underwent LIKE procedure for the correction of moderate to high hyperopia were included.

As the lenticule was extracted from the myopic donor eye, the lenticule was implanted under the flap (10 eyes) by femtosecond laser–assisted lenticule intrastromal keratoplasty (FS-LIKE) or into a pocket (10 eyes) by small incision lenticule intrastromal keratoplasty (SMI-LIKE). The uncorrected visual acuity, corrected distance visual acuity, subjective refraction, corneal topography and anterior segment optical coherence tomography were acquired preoperatively, 1 week, 1 month, 3 months and 6 months postoperatively.

No significant difference in efficacy indices or safety indices were found between both groups (all P < 0.05). There was a significantly positive correlation between lenticule refractive power (LRP) and achieved spherical equivalent (SE) refraction in both FS-LIKE group (r = 0.96, P < 0.01) and the SMI-LIKE group (r = 0.97, P < 0.01). Additionally, compared with the SMI-LIKE group, the LRP of the FS-LIKE group may equip with greater tendency of overcorrection. In the FS-LIKE group, 4 eyes (40%) were within ±0.50D of targeted refraction. In the SMI-LIKE group, 6 eyes (60%) were within ±0.50D of targeted refraction. No significant difference in postoperative SE was found between each follow-up in both groups (all P＞0.05).

FS-LIKE and SMI-LIKE showed similar acceptable efficacy, safety, predictability and stability in the correction of moderate to high hyperopia. Compared with SMI-LIKE which inserted the lenticule into a pocket, FS-LIKE may enable the lenticule under the flap to have greater refractive power as it cut the Bowmans membrance and anterior corneal stroma.