Hyperopic Lasik: Outcomes Across Low, Intermediate And High Astigmatism
Published 2026 - 44th Congress of the ESCRS
Reference: PP10.02 | Type: Free paper | DOI: 10.82333/yyqx-x870
Authors: Dr Waseem Nasser* 1 , Dr Adir Sommer 2 , Dr Margarita Safir 3 , Dr Dror Ben Ephraim Noyman 2 , Mr Tzahi Sela 4 , Mr Gur Munzer 4 , Prof. Igor Kaiserman 5 , Dr Eyal Cohen 6 , Prof. Michael Mimouni 7
1Ophthalmology,Rambam Health Care Campus,Haifa,Israel;Ruth and Bruce Rappaport Faculty of Medicine,Technion - Israel Institute of Technology,Haifa,Israel, 2Ophthalmology,Rambam Health Care Campus,Haifa,Israel, 3Ophthalmology,Rabin Medical Center,Petah Tikva,Israel;Sackler School of Medicine,Tel Aviv University,Tel Aviv,Israel, 4Care-Vision Laser Center,Tel Aviv,Israel, 5Ophthalmology,Barzilai Medical Center,Ashkelon,Israel;Faculty of Health Sciences,Ben-Gurion University of the Negev,Beer Sheba,Israel;Care-Vision Laser Center,Tel Aviv,Israel, 6Ophthalmology,Tel Aviv Sourasky Medical Center,Tel Aviv,Israel;Sackler School of Medicine,Tel Aviv University,Tel Aviv,Israel;Care-Vision Laser Center,Tel Aviv,Israel, 7Ophthalmology,Rambam Health Care Campus,Haifa,Israel;Ruth and Bruce Rappaport Faculty of Medicine,Technion - Israel Institute of Technology,Haifa,Israel;Care-Vision Laser Center,Tel Aviv,Israel
Purpose
To compare visual, refractive, and astigmatic vector outcomes of hyperopic LASIK among eyes with low, intermediate and high preoperative astigmatism.
Setting
Retrospective matched comparative study, Care Vision Laser Center, Tel Aviv, Israel.
Methods
This retrospective matched comparative study included patients aged 17 to 60 years who underwent hyperopic LASIK between 2013 and 2022 at Care Vision Laser Centers. Eyes were stratified by preoperative subjective cylinder magnitude as low (<1.00 D), intermediate (1.00–<3.00 D), or high (≥3.00 D). A 1:1:1 matching was performed for age, sex, year of surgery and preoperative subjective SEQ, yielding 46 eyes per group. Preoperative, intraoperative, and postoperative visual and refractive parameters were compared between the groups, using one-way ANOVA for continuous variables and chi-square for categorical variables. Astigmatic outcomes were assessed using Alpins vector analysis.
Results
Postoperative UCVA was 0.04±0.05, 0.06±0.10, and 0.15±0.11 logMAR (P<0.05), BCVA was 0.03±0.05, 0.05±0.09, and 0.11±0.09 (P<0.05) in the low, intermediate and high groups, respectively. SEQ was similar (0.00±0.69, −0.15±0.68, −0.12±0.65 D; P=0.55), residual cylinder increased across groups (−0.38±0.34, −0.61±0.55, and −0.88±0.57 D; P<0.05). Alpins vector analysis showed increasing TIA (0.57±0.19, 1.66±0.53, and 3.62±0.64 D; P<0.05), SIA of 0.70±0.36, 1.59±0.71, and 3.10±0.83 D (P<0.05) and DV of 0.53±0.29, 0.66±0.37, and 0.96±0.55 D (P<0.05). Correction index decreased (1.32±0.93, 0.97±0.31, and 0.85±0.16; P<0.05), and flattening index differed (1.14±0.85, 0.90±0.33, and 0.80±0.30; P<0.05). Safety & efficacy indices remained high (P>0.05).
Conclusions
Across the low, intermediate, and high astigmatism groups, hyperopic LASIK achieved similar postoperative spherical equivalent, with comparable safety and efficacy indices. Increasing preoperative astigmatism was associated with greater residual postoperative cylinder and higher difference vector, along with a lower correction index.