HYPEROPIC RESIDUAL REFRACTION CORRECTION AFTER LASIK WITH LENTICULE TRANSPLANTATION

To evaluate the efficacy of positive meniscus lenticule transplantation in correcting hyperopic residual refractive error after LASIK (Laser-Assisted in Situ Keratomileusis) through Q-value modulation.

Eye Hospital, Prishtina, Kosovo 

This study included 64 eyes of 32 patients (18 males, 14 females; mean age 45.1 ± 5.1 years, range 38–55) who had previously undergone LASIK for hyperopia correction and later presented with residual hyperopia ranging from +0.75 to +2.75 D and astigmatism from +0.75 to +2.50 D. Donor lenticules with refractive powers between –1.25 and –3.25 D were selected and customized to be 0.5 mm larger than the recipient’s mesopic pupil diameter. A target postoperative refraction of –0.50 D was chosen, and donor lenticules were matched accordingly. The original LASIK flap remained intact; instead, a new 140 µm intrastromal pocket was created using the SMILE module, maintaining a safe stromal margin above the pre-existing 110 µm LASIK flap. All patients completed a minimum 12-month postoperative follow-up.
(ClinicalTrials.gov Identifier: NCT04793893)

No intraoperative or postoperative complications were observed. At 1 year postoperatively, UDVA improved significantly from 0.47 ± 0.23 to 0.03 ± 0.02 logMAR (p < 0.001), and central corneal thickness (CCT) increased from 511.8 ± 21.8 µm to 561.3 ± 26.9 µm (p < 0.001). K1 and K2 steepened from 40.81 ± 1.45 D and 41.75 ± 1.39 D to 52.00 ± 1.87 D and 52.13 ± 2.00 D, respectively (p < 0.001). The Q-value shifted from –0.38 ± 0.03 to –0.70 ± 0.04 (p < 0.001), and RMS increased from 1.06 ± 0.19 to 1.88 ± 0.36 (p < 0.001). UNVA improved from J6 to J3 at 80 cm and from J7 to J2 at 40 cm.

By modulating the corneal Q-value, positive meniscus lenticule transplantation effectively corrects distance, intermediate, and near vision in eyes with residual hyperopia after LASIK.