One Year Outcomes of Photorefractive Keratectomy with the Application of Mitomycin-C in the Treatment of Mild to Moderate Hyperopia.

PURPOSE: To evaluate refractive and visual outcomes of photorefractive keratectomy with mitomycin-C. (PRK-MMC) for the treatment of mild to moderate hyperopia. MATERIALS AND METHODS: This case series enrolled 21 patients with up to +5.50 diopters (D) of hyperopia. All 42 eyes were treated with the Concerto (Wavelight) or the Technolas 217-Z (Bausch and Lomb) excimer laser. Outcome measures included best corrected distance vision acuity (BCVA) and uncorrected distance vision correction and refraction at 1, 3, 6, and 12 months postoperatively. RESULTS: Mean patient age was 44.8 ± 11.3 years. Preoperatively, mean manifest refractive spherical equivalent (MRSE) was + 2.00 D ± 0.76 D and mean spherical refractive error was + 2.57 D ± 0.87 D (range, +1.25 D to + 5.50 D). At 12 months postoperatively, mean MRSE was + 0.1 D ± 0.61 D. MRSE was within ± 0.50 D of emmetropia in 29 eyes (69%), and 18 eyes (43%) had 20/20 uncorrected distant visual acuity. BCVA increased by two lines or more in three eyes (7.1%) and one line in two eyes (4.7%); 31 eyes showed no change, three eyes (7.1%) lost one line, and three other eyes (7.1%) lost two lines of BCVA. No eyes lost more than two lines of BCVA. Complications included Grade 2 peripheral haze in two eyes which cleared by 12 months postoperatively. CONCLUSION: PRK-MMC was a safe and predictable method for the correction of mild to moderate hyperopia.

Visual Outcomes of Conductive Keratoplasty to Treat Hyperopia and Astigmatism After Laser in situ Keratomileusis and Photorefractive Keratectomy.

AIM: To determine the effect of conductive keratoplasty (CK) for the treatment of induced hyperopia and astigmatism after complicated myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). MATERIALS AND METHODS: In this interventional case series, 11 eyes of seven subjects with a history of previous LASIK or PRK with inadequate stromal bed or flaps complications were enrolled. Inclusion criteria included residual spherical hyperopia of 1.00 to 3.00 diopters (D) and cylinder of -0.75 to -3.00 D. The modified Refractec nomogram and the LightTouch technique of CK were performed on all eyes. To treat cylinder, a pair of spots per -0.75 D of cylinder were delivered to the flat meridian. Uncorrected visual acuity at near and far (UCVAN and UCVAF respectively, logMAR), best corrected VA at near and far (BCVAN and BCVAF respectively, logMAR) were measured. Refractive outcome, contrast sensitivity, wave front aberrations were measured preoperatively and postoperatively. Statistical analysis was performed with the Wilcoxon signed rank test and the repeated measures analysis of variance with P<0.05 indicating statistically significant change from preoperatively to 1 year postoperatively. RESULTS: The mean preoperative sphere (MS) was 2.57 ± 1.19 D and cylinder (MC) was -1.5 ± 0.49 D. Postoperatively, there was a significant decrease in MS to 0.36±0.98 D (P=0.003) and MC to -1.25 ± 0.76 D at 1 year (P<0.05, both cases). Spherical equivalent (SE) significantly decreased from +2.13 ± 1.09 D to -0.47 ± 1.29 D (P<0.001). The mean UCVAN significantly improved from 0.56 ± 0.32 preoperatively to 0.17 ±0.16 postoperatively (P=0.003). The mean UCVAF was 0.29 preoperatively and 0.22 postoperatively (P=0.353). Mean BCVAN was 0.18 and 0.02 after surgery, and mean BCVAF for far was 0.07 (P>0.05, both cases). CONCLUSIONS: CK is a predictable and reliable method to correct hyperopia after LASIK and PRK, however cylinder correction may induce irregular and unpredictable outcomes and a modified nomogram is required for further studies.

Contralateral comparison of visual outcome of AcrySof IQ and SA60AT intraocular lenses.

OBJECTIVE: To compare the visual performance of aspherical AcrySof IQ (SN60WF) and SA60AT spherical intraocular lenses after cataract surgery. DESIGN: Prospective comparative study. PARTICIPANTS: Seventy eyes of 35 patients who underwent phacoemulsification for cataract surgery. METHODS: The IQ lens was implanted in one eye and the SA60AT lens in the other eye of every patient. Refraction, uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) were measured 1 and 3 months after surgery. At 3 months' follow-up, the quality of vision, in terms of contrast sensitivity (CS) with and without glare and higher-order aberrations (HOA), was also determined. RESULTS: At 3 months postoperative, the mean UCVA in the IQ and SA60AT groups was 0.25 (SD 0.26) and 0.30 (SD 0.27), respectively, and BSCVA was 0.10 (SD 0.16) in both groups. Spherical refractive error was -0.56 (SD 1.03) D and -0.47 (SD 0.64) D in the IQ and SA groups, respectively. In photopic conditions without glare, IQ eyes had statistically significant better CS at 12 cycles per degree (cpd) and better function at 3 and 18 cpd, and in mesopic conditions without glare, IQ eyes also had better results at 3, 12, and 18 cpd. In mesopic conditions with glare, IQ eyes also had better CS in 6 and 18 cpd. In terms of aberrations, the IQ group had significantly (p < 0.05) lower spherical aberrations, root mean-square, and coma X and Y values with 6 mm pupil size than the SA group. CONCLUSIONS: In terms of refraction, no significant difference was found between these 2 types, but there was a difference in the quality of vision in photopic and mesopic conditions and also HOA. Those with reactive and dilated pupils, such as younger patients and night drivers, may be more satisfied with IQ aspherical lenses.