ESCRS - POCOR170 - Long-Term Outcomes Of Photorefractive Intrastromal Cross-Linking (Pixl) For Hyperopia: Up To 8 Years Of Follow-Up Data

Long-Term Outcomes Of Photorefractive Intrastromal Cross-Linking (Pixl) For Hyperopia: Up To 8 Years Of Follow-Up Data

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR170 | Type: Free paper | DOI: 10.82333/xjja-e187

Authors: Dr Zuzana Halasova* 1 , Dr Pavel Stodulka 1 , Mrs Simona Jiratkova 2 , Dr Martin Slovak 2 , Dr Eva Randarova 2 , Dr Lucia Skrovinova 1

1Department of Ophthalmology 3FM CU and UHKV,Charles University, Third Faculty of Medicine,Prague,Czech Republic;Gemini eye clinic,Zlin,Czech Republic, 2Gemini eye clinic,Zlin,Czech Republic

Purpose

To evaluate the long-term effectiveness and safety of photorefractive intrastromal cross-linking (PiXL) in the treatment of hyperopia up to an 8-year follow-up period.

Setting

Gemini Eye Clinic, Zlin, Czech Republic.

Methods

Design: Prospective single-center follow-up study.

Twenty-three low hyperopic eyes of 20 pseudophakic patients underwent PiXL according to a standardized protocol. Visual acuity, subjective distance refraction, keratometry, corneal topography, pachymetry, endothelial cell density (ECD), and adverse events were assessed during 6–8-year follow-up.

Results

Median manifest refraction spherical equivalent decreased by −0.69 D, closely matching the intended −0.75 D target, with long-term stability. Uncorrected distance visual acuity improved by a median −0.19 logMAR; corrected distance visual acuity remained stable with no eyes losing lines. Median keratometric steepening was observed (K1 +0.3 D, K2 +0.4 D, Kmean +0.28 D) and remained stable long term. Corneal astigmatism, higher-order aberrations, and spherical aberration showed minimal change. ECD and corneal thickness were preserved. Mild peripheral corneal haze occurred in one eye; no serious adverse events were reported. Refractive accuracy was high: 83% of eyes were within ±0.50 D and 96% within ±1.00 D of target.

Conclusions

Hyperopic PiXL provides a safe, minimally invasive method to correct low residual hyperopia in pseudophakic eyes, achieving predictable, stable hyperopic correction with long-term preservation of corneal structure and visual acuity.