Corneal aberrations and objective visual quality after hyperopic laser in situ keratomileusis using the Esiris excimer laser

Purpose

To evaluate the changes in visual performance and ocular optical quality after hyperopic laser in situ keratomileusis (LASIK) using the Esiris excimer laser (Schwind eye-tech-solutions).

Setting

Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain.

Methods

Excimer laser surgery was performed with the Esiris laser in 51 eyes of 29 patients with hyperopia or hyperopic astigmatism. The follow-up was 6 months. Changes in visual acuity, refraction, and corneal and ocular wavefront aberrations (6.0 mm pupil) were recorded and analyzed.

Results

The mean preoperative sphere was +4.45 diopters (D) ± 1.08 (SD) (range +2.50 to +7.25 D) and the mean preoperative cylinder, −0.55 ± 0.36 D (range 0.00 to 1.00 D). Ten eyes (19.61%) had a LASIK enhancement during the follow-up for the correction of the residual refractive error and were excluded from the refractive analysis. Of the 41 remaining eyes, 95.12% had the same or improved distance best spectacle-corrected visual acuity (BSCVA) 6 months after surgery; 90.25% had no change or a gain of lines of near BSCVA. Moreover, 80.50% of eyes were within ±0.50 D of emmetropia. Regarding corneal aberrations, statistically significant changes were observed in higher-order aberrations (HOAs), coma-like aberrations, and the primary spherical aberration coefficient Z(4,0), which changed from positive to negative values (all P<.01). Regarding total ocular aberrations, statistically significant changes were observed in total and higher-order root-mean-square values (P<.01).

Conclusions

Hyperopic LASIK using the Esiris excimer laser for the correction of 2nd-order aberrations was safe and effective. Ocular and corneal HOAs increased significantly postoperatively.