To investigate refractive outcomes and induction of corneal higher order aberrations (HOA) in eyes that underwent laser-assisted in situ keratomileusis (LASIK) for high hyperopia correction using an aberration neutral profile with corneal vertex centration and asymmetric offset.
Methods
A total of 24 consecutive patients (38 eyes) who underwent LASIK by one surgeon using AMARIS 750S excimer laser and a Carriazo-Pendular microkeratome for flap creation were retrospectively analyzed. Eyes targeted for plano and with correction in the maximum hyperopic meridian strictly higher than +4D were included in the retrospective analysis. Patients were reviewed at 1, 3, and 6 months postoperatively. Postoperative monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, and corneal wavefront aberrations were compared with respective preoperative metrics.
Results
Mean preoperative spherical equivalent and refractive astigmatism was +4.07 ± 0.90 D and 1.37 ± 1.26 D, respectively, reducing to +0.28 ± 0.58D (p<0.0001) and 0.49 ± 0.47 D (p = 0.0001) at the last postoperative visit. Six months postoperatively, 78% of eyes achieved a UDVA of 20/25 or better. No eye lost more than 2 Snellen lines of CDVA at any follow-up. There was a statistically significant induction of vertical trefoil (+0.104 ± 0.299 µm, p<0.05), vertical coma (-0.181 ± 0.463 µm, p<0.01), horizontal coma (+0.198 ± 0.663 µm, p<0.05), spherical aberration (-0.324 ± 0.281 µm, p<0.0001), secondary vertical trefoil (+0.018 ± 0.044 µm, p<0.01), and secondary horizontal coma (+0.026 ± 0.083 µm, p<0.05)
Conclusions
Laser-assisted in situ keratomileusis for high hyperopia using corneal vertex centration with asymmetric offset results in significant improvement in refraction and visual acuity although affected by significant induction of some higher order aberrations.
AzarDTPrimackJDTheoretical analysis of ablation depths and profiles in laser in situ keratomileusis for compound hyperopic and mixed astigmatism.J Cataract Refract Surg2000; 26(8):1123–1136
2.
LlorenteLBarberoSMerayoJMarcosSTotal and corneal optical aberrations induced by laser in situ keratomileusis for hyperopia.J Refract Surg2004;20(3):203–216
3.
KohnenTMahmoudKBührenJComparison of corneal higher-order aberrations induced by myopic and hyperopic LASIK.Ophthalmology2005;112(10):1692
4.
AlióJLPiñeroDPEspinosaMJCorralMJCorneal aberrations and objective visual quality after hyperopic laser in situ keratomileusis using the Esiris excimer laser.J Cataract Refract Surg2008;34(3):398–406
5.
ArtalPChenLFernándezEJSingerBManzaneraSWilliamsDRNeural compensation for the eye's optical aberrations.J Vis2004;4(4):281–287
6.
OliverKMO’BrartDPStephensonCGet al.Anterior corneal optical aberrations induced by photorefractive keratectomy for hyperopia.J Refract Surg2001;17(4):406–413
7.
WangLKochDDAnterior corneal optical aberrations induced by laser in situ keratomileusis for hyperopia.J Cataract Refract Surg2003;29(9):1702–1708
8.
de OrtuetaDArba MosqueraSBaatzHAberration-neutral ablation pattern in hyperopic LASIK with the ESIRIS laser platform.J Refract Surg2009;25(2):175–184
9.
HashemiHKhabazKhoobMYazdaniKMehravaranSJafarzadehpurEFotouhiADistribution of angle kappa measurements with Orbscan II in a population-based survey.J Refract Surg2010;26(12):966–971
10.
MoshirfarMHogganRNMuthappanVAngle Kappa and its importance in refractive surgery.Oman J Ophthalmol2013; 6(3):151–158
11.
BasmakHSahinAYildirimNPapakostasTDKanellopoulosAJMeasurement of angle kappa with synoptophore and Orbscan II in a normal population.J Refract Surg2007;23(5) 456–460
12.
KermaniOOberheideUSchmiedtKGertenGBainsHSOutcomes of hyperopic LASIK with the NIDEK NAVEX platform centered on the visual axis or line of sight.J Refract Surg2009;251 Suppl:S98–S103
13.
PandeMHillmanJSOptical zone centration in keratorefractive surgery. Entrance pupil center, visual axis, coaxially sighted corneal reflex, or geometric corneal center?Ophthalmology1993;100(8):1230–1237
14.
ChangDHWaringGOIVThe subject-fixated coaxially sighted corneal light reflex: a clinical marker for centration of refractive treatments and devices.Am J Ophthalmol2014;158(5) 863–874
15.
Arba MosqueraSVermaSMcAlindenCCentration axis in refractive surgery.Eye Vis (Lond)2015;2:4
16.
NarváezJBrucksMZimmermanGBekendamPBaconGSchmidKIntraoperative cyclorotation and pupil centroid shift during LASIK and PRK.J Refract Surg2012;28(5) 353–357
17.
de OrtuetaDSchreygerFDCentration on the cornea vertex normal during hyperopic refractive photoablation using videokeratoscopy.J Refract Surg2007;23(2):198–200
18.
ChanCCBoxer WachlerBSCentration analysis of ablation over the coaxial corneal light reflex for hyperopic LASIK.J Refract Surg2006;22(5):467–471
19.
Arba MosqueraSEweringTNew asymmetric centration strategy combining pupil and corneal vertex information for ablation procedures in refractive surgery: theoretical background.J Refract Surg2012;28(8):567–573
20.
YoungJJSchallhornSCBrownMCHettingerKAHettingerKAEffect of keratometry on visual outcomes 1 month after hyperopic LASIK.J Refract Surg2009;257 Suppl:S672–S676
21.
ArbelaezMCVidalCArba-MosqueraSClinical outcomes of corneal vertex versus central pupil references with aberration-free ablation strategies and LASIK.Invest Ophthalmol Vis Sci2008;49(12):5287–5294
22.
ReinsteinDZArcherTJRandlemanJBJRS standard for reporting astigmatism outcomes of refractive surgery.J Refract Surg2014;30(10):654–659
23.
ArbelaezMCVidalCArba-MosqueraSBilateral Symmetry before and Six Months after Aberration-FreeTM Correction with the SCHWIND AMARIS Total Tech Laser: Clinical Outcomes.J Opt2010;3:20–28
24.
NanbaAAmanoSOshikaTet al.Corneal higher order wavefront aberrations after hyperopic laser in situ keratomileusis.J Refract Surg2005;21(1):46–51
25.
WangLKochDDAnterior corneal optical aberrations induced by laser in situ keratomileusis for hyperopia.J Cataract Refract Surg2003;29(9):1702–1708
26.
ChenCCIzadshenasARanaMAAAzarDTCorneal asphericity after hyperopic laser in situ keratomileusis.J Cataract Refract Surg2002;28(9):1539–1545
27.
AlióJLPiñeroDPEspinosaMJCorralMJCorneal aberrations and objective visual quality after hyperopic laser in situ keratomileusis using the Esiris excimer laser.J Cataract Refract Surg2008;34(3):398–406
28.
ReinsteinDZGobbeMArcherTJCoaxially sighted corneal light reflex versus entrance pupil center centration of moderate to high hyperopic corneal ablations in eyes with small and large angle kappa.J Refract Surg2013;29(8):518–525
29.
TaberneroJBenitoAAlcónEArtalPMechanism of compensation of aberrations in the human eye.J Opt Soc Am A Opt Image Sci Vis2007;24(10):3274–3283
30.
Cobo-SorianoRLlovetFGonzález-LópezFDomingoBGómez-SanzFBavieraJFactors that influence outcomes of hyperopic laser in situ keratomileusis.J Cataract Refract Surg2002;28(9) 1530–1538
31.
WilliamsLBDaveSBMoshirfarMCorrelation of visual outcome and patient satisfaction with preoperative keratometry after hyperopic laser in situ keratomileusis.J Cataract Refract Surg2008;34(7):1083–1088
32.
VarleyGAHuangDRapuanoCJSchallhornSBoxer WachlerBSSugarAOphthalmic Technology Assessment Committee Refractive Surgery Panel, Ameican Academy of Ophthalmology. LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism: a report by the American Academy of Ophthalmology.Ophthalmology2004;111(8):1604–1617
33.
ReinsteinDZArcherTJGobbeMSilvermanRHColemanDJEpithelial thickness after hyperopic LASIK: three-dimensional display with Artemis very high-frequency digital ultrasound.J Refract Surg2010;26(8):555–564
34.
de OrtuetaDArba-MosqueraSBaatzHTopographic changes after hyperopic LASIK with the SCHWIND ESIRIS laser platform.J Refract Surg2008;24(2):137–144
35.
de OrtuetaDArba MosqueraSTopographic stability after hyperopic LASIK.J Refract Surg2010;26(8):547–554
36.
Arba MosqueraSde OrtuetaDTheoretical influence of decentred ablations on induced Coma aberrations.J Emmetropia2011;2:153–158
37.
SewardMSOralDBowmanRWEl-AghaMSCavanaghHDMcCulleyJPComparison of LADARVision and Visx Star S3 laser in situ keratomileusis outcomes in myopia and hyperopia.J Cataract Refract Surg2003;29(12):2351–2357
38.
AlióJLEl AswadAVega-EstradaAJavaloyJLaser in situ keratomileusis for high hyperopia (>5.0 diopters) using optimized aspheric profiles: efficacy and safety.J Cataract Refract Surg2013;39(4):519–527
39.
ArbelaezMCVidalCArba-MosqueraSSix-month experience Hyperopic correction with the SCHWIND AMARIS Total-Tech Laser: Clinical Outcomes.J Opt2010;3:198–205
40.
GatellJArba MosqueraSComparison of the induced anterior corneal spherical and comatic aberrations between the classic profiles of the ESIRIS system and the aspheric profiles of the AMARIS system.J Emmetropia2011;2:37–44
41.
ArbelaezMCVidalCArba MosqueraSHyperopia and hyperopic astigmatism correction with the SCHWIND ESIRIS: 1-year results.J Emmetropia2011;2:131–135
42.
CamellinMArba MosqueraSAspheric Optical Zones in hyperopia with the SCHWIND AMARIS.J Opt2011;04:85–94
43.
Arba MosqueraSde OrtuetaDMultifocality changes after LASIK.JOptom2012;05:202–208
44.
HabibollahiAHashemiHSeyedianMAet al.One Year Outcomes of Photorefractive Keratectomy with the Application of Mitomycin-C in the Treatment of Mild to Moderate Hyperopia.Middle East Afr J Ophthalmol2015;22(4):484–488
45.
ZhouXLiTChenZNiuLZhouXZhouZNo change in anterior chamber dimensions after femtosecond LASIK for hyperopia.Eye Contact Lens2015;41(3):160–163
46.
LeccisottiAFemtosecond laser-assisted hyperopic laser in situ keratomileusis with tissue-saving ablation: analysis of 800 eyes.J Cataract Refract Surg2014;40(7):1122–1130
47.
SálesCSMancheEEOne-year eye-to-eye comparison of wavefront-guided versus wavefront-optimized laser in situ keratomileusis in hyperopes.Clin Ophthalmol2014;8:2229–2238
48.
AslanidesIMMukherjeeANAdjuvant corneal crosslinking to prevent hyperopic LASIK regression.Clin Ophthalmol2013;7:637–641
49.
QuitoCFAgahanALEvangelistaRPLong-Term Followup of Laser In Situ Keratomileusis for Hyperopia Using a 213 nm Wavelength Solid-State Laser.ISRN Ophthalmol2013Mar32013:276984
50.
KanellopoulosAJKahnJTopography-guided hyperopic LASIK with and without high irradiance collagen cross-linking: initial comparative clinical findings in a contralateral eye study of 34 consecutive patients.J Refract Surg2012;2811 Suppl:S837–S840
51.
KanellopoulosAJTopography-guided hyperopic and hyperopic astigmatism femtosecond laser-assisted LASIK: long-term experience with the 400 Hz eye-Q excimer platform.Clin Ophthalmol2012;6:895–901
52.
El-HelwMAEmarahAMPredictability and stability of refraction with increasing optical zone diameter in hyperopic LASIK.Clin Ophthalmol2010;4:455–458
53.
AntoniosRArba MosqueraSAwwadSTHyperopic laser in situ keratomileusis: comparison of femtosecond laser and mechanical microkeratome flap creation.J Cataract Refract Surg2015;41(8):1602–1609
54.
Plaza-PucheABYebanaPArba-MosqueraSAlióJLThree-Year Follow-up of Hyperopic LASIK Using a 500-Hz Excimer Laser System.J Refract Surg2015;31(10):674–682
55.
Plaza-PucheABAswadAEArba-MosqueraSWróbel-DudzinskaDAbdouAAAlióJLOptical Profile Following High Hyperopia Correction With a 500-Hz Excimer Laser System.J Refract Surg2016;32(1):6–13
56.
Arba-MosqueraSde OrtuetaDLASIK for Hyperopia Using an Aberration-Neutral Profile With an Asymmetric Offset Centration.J Refract Surg2016;32(2):78–83
57.
Adib-MoghaddamSArba-MosqueraSWalter-FinckeRSoleyman-JahiSAdili-AghdamFTransepithelial Photorefractive Keratectomy for Hyperopia: A 12-Month Bicentral Study.J Refract Surg2016;32(3):172–180
58.
McAlindenCSkiadaresiEMooreJEHyperopic LASEK treatments with mitomycin C using the SCHWIND AMARIS.J Refract Surg2011;27(5):380–383
59.
AmigóABonaque-GonzálezSGuerras-ValeraEControl of Induced Spherical Aberration in Moderate Hyperopic LASIK by Customizing Corneal Asphericity.J Refract Surg2015;31(12) 802–806
60.
DurrieDSSmithRTWaringGOIVStahlJESchwendemanFJComparing conventional and wavefront-optimized LASIK for the treatment of hyperopia.J Refract Surg2010;26(5):356–363
61.
IvarsenANæserKHjortdalJLaser in situ keratomileusis for high astigmatism in myopic and hyperopic eyes.J Cataract Refract Surg2013;39(1):74–80
62.
BababeygySRZoumalanCIChienFYMancheEEWavefront-guided laser in situ keratomileusis retreatment for consecutive hyperopia and compound hyperopic astigmatism.J Cataract Refract Surg2008;34(8):1260–1266
63.
KeirNJSimpsonTHutchingsNJonesLFonnDOutcomes of wavefront-guided laser in situ keratomileusis for hyperopia.J Cataract Refract Surg2011;37(5):886–893
