Diode laser thermal keratoplasty to correct hyperopia

PURPOSE: We investigated long-term efficacy, predictability, stability, and safety of diode laser thermal keratoplasty (DTK) to correct hyperopia. METHODS: DTK was performed on 24 eyes (18 patients). Eight eyes with high hyperopia (mean +4.75 +/- 0.63 D; range +3.50 to +5.50 D) received 12 pairs of coagulation spots at 6-mm and 7-mm treatment zone diameters; eight eyes with low hyperopia (mean +2.25 +/- 0.40 D; range +1.50 to +2.75 D) received eight coagulation spots at 8 mm, and eight eyes with low hyperopia (mean +1.50 +/- 0.46 D; range +1.25 to +2.25 D) were treated to induce mild myopia (-1.50 D) in the non-dominant eye for monovision using eight pairs of spots at 7 and 8-mm diameters. Minimum follow-up was 18 months. RESULTS: Mean decrease in cycloplegic refraction at 18 months was 5.00 +/- 0.38 D in the high hyperopia group, 1.75 +/- 0.19 D in the low hyperopia group, and 3.25 +/- 0.27 D in the presbyopia group. Mean increase in uncorrected visual acuity (UCVA) at 18 months was 8.125 +/- 2.1 Snellen lines in the high hyperopia group, 6.625 +/- 0.744 lines for low hyperopia; decrease of 1.00 +/- 1.85 line occurred in the presbyopia group. Near UCVA in the presbyopia group improved by 3.875 +/- 0.83 Jaeger lines. Best spectacle-corrected visual acuity (BSCVA) was restored by 3 months in all eyes. CONCLUSION: DTK was an effective and fairly safe procedure, with reasonable predictability and stability. Nomograms for laser energy level, treatment zone diameter, and number of spots need improvement.