Excimer laser photorefractive keratectomy for low hyperopia: Safety and efficacy

Purpose: To assess the safety and efficacy of photorefractive keratectomy (PRK) to correct low hyperopia. Setting: University of Ottawa Eye Institute, Ottawa General Hospital, Ontario, Canada. Methods: Twenty-five eyes with refractions of +1.00 to +4.00 diopters (D) and cylinder of 1.00 D or less were treated for hyperopia with the VISX Star excimer laser system using a refined ablation architecture. Thorough visual assessments were performed preoperatively (baseline) and 1, 3, and 6 months postoperatively. Complications were recorded and the level of patient satisfaction was noted. Results: Mean spherical equivalent at 6 months was +0.27 D ± 0.55 (SD), which was an 89% reduction over baseline. Eighty-four percent of patients gained two to seven lines of near uncorrected visual acuity (UCVA) and 1 patient (4%) lost more than one line. Eight percent achieved 20/25 or better UCVA. Approximately half realized their preoperative distance best corrected visual acuity (BCVA) by 1 month. By the end of the study, all patients had improved, achieved, or were within one line of their baseline distance BCVA. There were some slight reductions in lower contrast acuity at 6 months, although dim lighting conditions did not further reduce these acuities. Most patients had no clinically meaningful change in cylinder. The most common complications included early, transient corneal surface irregularities and visual symptoms and trace haze (grade ≤0.5) in 14 of 23 patients at 6 months. All but 1 patient expressed a high degree of satisfaction. Conclusions: These results support the hypothesis that PRK shows great promise as a safe and effective treatment for low hyperopia. There were no significant complications and no decentered ablations. The slight regression occurred with or without the presence of trace haze. Overall, refractive stability was encouraging, although longer follow-up is needed.