Correction of Moderate to High Hyperopia With Implantation of an Allogeneic Refractive Lenticule

PURPOSE: To describe the visual outcomes of correcting moderate to high hyperopia after two different surgical procedures of lenticular implantation. METHODS: This prospective small case series study used epikeratophakia combined with transepithelial phototherapeutic keratectomy (PTK-EP) and femtosecond laser–assisted lenticule intrastromal keratoplasty (LIKE) using myopic small incision lenticule extraction (SMILE)–derived refractive lenticule for correcting hyperopia ranging from +3.00 to +10.00 diopters (D). The implanted refractive lenticule was matched with the recipient's manifest refraction. The visual, refractive, corneal tomographic, and epithelial thickness outcomes were analyzed after surgery. RESULTS: Four eyes underwent PTK-EP and 6 eyes underwent LIKE. At the last postoperative visit, 6 of 10 eyes had uncorrected distance visual acuity equal to or better than the preoperative corrected distance visual acuity (CDVA). No eyes lost one line or more of CDVA postoperatively. Postoperative spherical equivalent was within ±0.50 D of the target for 9 of 10 eyes. Posterior corneal curvature slightly steepened for PTK-EP and LIKE. Postoperative epithelial thickness demonstrated the expected doughnut pattern in both groups characterized by epithelium in the central zone (5 mm) thinner than that in the peripheral zone (5 to 7 mm). CONCLUSIONS: Visual outcomes, refraction, posterior corneal surface changes, and epithelial remodeling after PTKEP or LIKE show a potentially useful modality for correcting moderate to high hyperopia. [ J Refract Surg . 2020;36(11):772–779.]