Correlation of visual outcome and patient satisfaction with preoperative keratometry after hyperopic laser in situ keratomileusis

Purpose

To prospectively study the dependence of visual outcomes and patient satisfaction on corneal keratometry (K) in hyperopic laser in situ keratomileusis (LASIK).

Setting

John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA.

Methods

Twenty-six patients (49 eyes) who had hyperopic LASIK from January to October 2005 were prospectively studied. Twelve patients (24 eyes) with a preoperative K value less than 43.0 diopters (D) (Group 1) were compared with 14 patients (25 eyes) with a preoperative K value greater than 44.0 D (Group 2).

Results

The mean preoperative hyperopia was +3.44 D (range +1.57 to +5.25 D). Ten patients in Group 2 and 1 patient in Group 1 lost 2 or more lines of best spectacle-corrected visual acuity (BSCVA). There was a statistically significant difference in subjective patient satisfaction (scale 1 to 4; 4 = most satisfied) between Group 1 and Group 2 (mean 2.75 ± 0.61 and 1.52 ± 0.66, respectively) (P<.0001). Group 2 had a statistically significantly higher dryness score (scale 0 to 3; 3 = severe) (mean 1.84 ± 0.70 versus 0.17 ± 0.38) (P<.0001). There was no between-group difference in the degree of preoperative hyperopia or keratometric change.

Conclusions

An increased incidence of loss of BSCVA and decreased patient satisfaction was associated with a preoperative K value greater than 44.0 D in hyperopic LASIK, indicating caution is required when performing LASIK in eyes with moderate to high hyperopia and steep preoperative corneal keratometry.