Is LASIK an effective treatment modality for hyperopia or hyperopic astigmatism?

Purpose: To assess the efficacy, safety and stability of LASIK surgery for treatment of low to moderate degree hyperopia and hyperopic astigmatism

Patients and methods: The study included 34 eyes in 17 patients [7 males, and 10 females] with bilateral low to moderate degree hyperopia or hyperopic astigmatism. Their mean age +/- SD was 26.7 +/- 4.1 years. Range of hyperopia was between +1.75 to +5.50 D, astigmatic errors range was 0.00 to -1.50 D while the spherical equivalent refraction ranged from +1.4 to + 4.8 D. Patients included in this study had a stable refraction for at least one year. All patients underwent bilateral LASIK surgery in the same session in Dr Soliman Faqeeh Hospital [DSFH] and the Eye Subspecialty Center [ESC]using the ALLEGRETTO EYE - Q Excimer Laser machine

Results: UCVA after one year was 20/20 or better in 30 eyes [88.2%], 20/30 or better in 32 eyes [94.1%] and 20/40 or better in 34 eyes [100%], while BCVA was 20/20 or better in 33 eyes [97.1%] and 20/40 or better in 34 eyes [100%]. There was no decrease in UCVA after LASIK surgery. One eye [2.9%] showed 2 lines drop in BCVA after LASIK surgery due to broad wrinkles of the flap. The flap was lifted after one day; trial to flatten the wrinkles showed incomplete resolution. One eye [2.9%] showed diffuse lamellar keratitis [DLK] at one week after LASIK surgery. There was regression in the manifest spherical equivalent refraction one year after LASIK surgery as compared with that at one month, but the difference was statistically insignificant [P=O.46]. The mean score of patient satisfaction was 9.4 at one year postoperatively

Conclusion: LASIK surgery is a safe, predictable, stable and effective for treatment of mild to moderate degree hyperopia and hyperopic astigmatism. No significant regression in UCVA, BCVA or manifest refraction was reported up to 12 months follow up

Relaesable scleral flap suture in trabeculectomy: preliminary results of a new technique

To demonstrate a technique for a releasable scleral flap suture placed to reduce post-trabeculectomy complications. Under a fornix based conjunctival flap, a rectangular partial thickness scieral flap is fashioned. A scierostomy is made followed by a peripheral iridectomy and the scieral flap is secured. A trapezoid suture is then placed from the sciera across the scleral flap to exit on the corneal surface and then tightend under the conjunctival flap which is then secured. During the follow-up, this suture can be safely removed on the slit lamp if the lOP is high. If the lOP is ideal, the suture can be left in place. Immediate postoperative complications as flat anterior chamber and choroidal detachment didn't occur. The suture was removed only if the filtration was not sufficient and the lOP was high. The releasable scieral flap suture was effective in preventing post trabeculectomy complications. In addition, it can be easily removed on the slit lamp without the need to fish under the conjunctiva, or to search for equipments as lasers