Super vision: dream or reality.

PURPOSE: To present and evaluate the early clinical experience of laser in situ keratomileusis (LASIK) using the custom guided corneal ablation system by NIDEK, which includes an OPD-Scan, Final Fit program, and Nidek Multipoint EC-5000 excimer laser. METHODS: The OPD-Scan diagnostic system containing a scanning slit refractometer using skiascopic technology with simultaneous Placido disc corneal topography is described. The Final Fit program that converts the refractive error and topography data into custom algorithms to couple with the Nidek EC-5000 Multipoint excimer laser is explained. Thirty-eight cases of LASIK using the Nidek MK-2000 microkeratome and the Nidek Multipoint excimer laser with custom and conventional treatments are presented. Eyes were divided into two groups: LASIK custom group and LASIK conventional group. RESULTS: Predictability and attempted correction were similar in both groups. One month after surgery, all eyes were between +/-1 line of visual acuity. In the custom LASIK group there was a gain of one line in 50% and two lines of visual acuity in 25% of patients at 1 month after surgery. In the conventional LASIK group there was no gain of lines of visual acuity at 1 month. In the comparative group (one eye custom LASIK and the other eye conventional LASIK) there was data available for six patients (75%). At one month, all patients preferred the vision in their custom LASIK-treated eye. CONCLUSION: The Nidek LASIK custom and conventional treatments were safe and predictable. There was more accuracy, better visual acuity, and more subjective satisfaction in the custom LASIK custom treatment group.

Laser in situ keratomileusis for hyeropia and hyperopic astigmatism.

PURPOSE: To evaluate the efficacy, stability, and safety of laser in situ keratomileusis (LASIK) for hyperopia and hyperopic astigmatism using a prospective clinical trial. METHODS: LASIK was performed using the Automatic Corneal Shaper and the Keracor 117C excimer laser on 192 hyperopic eyes with astigmatism of less than 1.00 D (spherical group) and 164 hyperopic eyes with corneal astigmatism of 1.00 to 7.50 D (toric group). RESULTS: At 12 months after LASIK, 110 eyes were available for follow-up examination. In low spherical hyperopia (+1.00 to +3.00 D), 13 eyes (55%) were within +/-0.50 D of emmetropia and none lost 2 or more lines of spectacle-corrected visual acuity. In low toric hyperopia (+1.00 to +3.00 D), 14 eyes (61%) were within +/-0.50 D and none lost 2 or more lines of spectacle-corrected visual acuity. In moderate spherical hyperopia (+3.10 to +5.00 D) 9 eyes (44%) were within +/-0.50 D and none lost 2 or more lines of spectacle-corrected visual acuity and in moderate toric hyperopia (+3.10 to +5.00 D) 5 eyes (36%) were within +/-0.50 D and 2 eyes (14%) lost 2 or more lines of spectacle-corrected visual acuity. In high spherical hyperopia (+5.10 to +9.00 D), 6 eyes (38%) were within +/-0.50 D and 2 eyes (13%) lost 2 or more lines of spectacle-corrected visual acuity, and in high toric hyperopia (+5.10 to +9.50 D) 4 eyes (31%) were within +/-0.50 D and 2 eyes (15%) lost 2 or more lines of spectacle-corrected visual acuity. CONCLUSIONS: LASIK seems to be reasonably effective and safe in spherical hyperopia of +1.00 to +5.00 D but less effective for hyperopic astigmatism. For hyperopia greater than +5.00 D, loss of spectacle-corrected visual acuity occurred in a significant number of eyes and accuracy was sufficiently poor to advise against LASIK in these eyes.