Three-Year Follow-up of Hyperopic LASIK Using a 500-Hz Excimer Laser System

PURPOSE: To evaluate the long-term visual, refractive, and corneal aberrometric outcomes and regression of the achieved correction of hyperopia with a sixth-generation excimer laser. METHODS: This retrospective, consecutive, observational case series study comprised 86 eyes of 44 patients who underwent LASIK to correct hyperopia with a postoperative follow-up of 3 years. LASIK procedures were performed using the sixth-generation Amaris excimer laser (Schwind eye-tech-solutions GmbH and Co., Kleinostheim, Germany). Visual acuity, manifest refraction, corneal topography, and aberrometry were evaluated in the follow-up. RESULTS: Three years postoperatively, 65 eyes (76%) had an uncorrected distance visual acuity of 20/20 or better. Five eyes (6.2%) lost one or more lines of corrected distance visual acuity. Sixty eyes (70%) had a spherical equivalent within ± 0.50 diopters (D). There was regression of 0.47 D between 3 and 36 months postoperatively. Statistically significant differences were found in spherical equivalent between 3 and 36 months (P < .01), but no differences were observed between 12 and 36 months (P = .08). A flattening of 0.16 D was observed between 3 and 36 months after surgery in the mean simulated keratometry. A significant increase of root mean square spherical-like, coma-like, and higher-order aberrations (P < .01) were observed postoperatively. Twenty-five eyes (29%) required re-treatment. CONCLUSIONS: Treatment of hyperopia using the sixth-generation Amaris excimer laser provides good results in terms of efficacy, safety, predictability, and visual outcomes after 3 years. The refractive stability shows a significant regression in the first 12 months after surgery with more stable results from 12 months postoperatively.