Laser in situ keratomileusis using the Nidek EC-5000 or the Alcon LADARVision 4000 systems

PURPOSE: To compare the refractive results of eyes with low to moderate myopia that underwent laser in situ keratomileusis with either the Nidek EC-5000 or the Alcon LADARVision 4000 excimer laser systems. METHODS: We performed a retrospective review of 114 LASIK procedures with either the Nidek EC-5000 (54 eyes) or the Alcon LADARVision 4000 (60 eyes) excimer laser systems. Preoperative refractive errors were similar and both populations were treated during the same time period. Data analyzed included uncorrected visual acuity (UCVA), spherical magnitude, spherical equivalent refraction, astigmatism power, astigmatism axis, and vector astigmatism change. RESULTS: Results at 6 months were analyzed. Spherical correction change was a mean -3.95 D for Nidek treated eyes and a mean -4.53 D for LADARVision treated eyes (P = .20). Mean spherical equivalent refraction change was -3.70 D for Nidek eyes and -4.20 D for LADARVision eyes (P = .23). Mean change in UCVA (LogMAR) was 1.05 for Nidek eyes and 0.99 for LADARVision eyes (P = .40). Mean astigmatism magnitude change was 0.71 D for Nidek eyes and 0.77 D for LADARVision eyes (P = .63). Mean vector-corrected astigmatism change was 0.93 D for Nidek eyes and 1.00 D for LADARVision eyes (P = .63). Mean vector-corrected astigmatism axis for Nidek eyes was 3.08 D and for LADARVision eyes 6.58 D (P = .70). CONCLUSION: There was no significant difference in refractive results in eyes treated with the Alcon LADARVision 4000 or the Nidek EC-5000 excimer laser systems. Inherent differences between the two laser systems are highlighted.     

Laser in situ keratomileusis for primary hyperopia

PURPOSE: To evaluate the efficacy, predictability, stability, and safety of hyperopic laser in situ keratomileusis (H-LASIK) over a 24-month period and analyze topographic changes after H-LASIK to assess topographic pseudokeratectasia (TPKE) following H-LASIK. SETTING: Eye Institute of Utah, Salt Lake City, Utah, USA. METHODS: This prospective study included 139 eyes of 77 patients having H-LASIK for primary hyperopia. The mean follow-up was 15.6 months +/- 7.6 (SD) (range 6 to 48 months). One hundred twenty-two eyes (88%) were followed at 1 year and 36 eyes (26%) at 24 months. Topographic pseudokeratectasia was defined as 1 or more positive keratoconus screening findings in an eye with topographic central or inferior steepening detected by the Topography Modeling System but without corneal thinning or progressive change. RESULTS: The mean spherical equivalent manifest refraction was +2.39 +/- 0.99 diopter (D) preoperatively and -0.05 +/- 0.61 D at the last visit. Ninety-one percent of eyes were within +/-1.00 D of emmetropia and 71% of the eyes were within +/-0.50 D. Uncorrected visual acuity of 20/20 or better was present in 42%, 20/25 in 63%, and 20/40 or better in 93% of eyes. Loss of 2 lines of BSCVA occurred in 2 eyes (1.4%). In 1 eye, ischemic optic neuropathy occurred, and in another, choroidal neovascularization developed postoperatively. Topographic pseudokeratectasia was detected in 28% to 56% of eyes postoperatively. No significant difference between postoperative visual and refractive outcome, regression, or irregularity was found between the eyes with or without TPKE. CONCLUSION: Hyperopic LASIK appears to be an effective, predictable, and safe procedure to correct low to moderate primary hyperopia. Topographic pseudokeratectasia, which was observed after H-LASIK with a keratoconus-like topographic pattern in otherwise normal eyes, may represent a relatively static condition.     

激光角膜原位磨镶术治疗远视的实验研究

目的：评价激光角膜原位磨镶术（ＬＡＳＩＫ）治疗对高度远视的效果和安全性。方法：选择日本大耳兔１２ 只,根据左右眼将其分为两组。应用吸引环和微型角膜刀在兔角膜上做一带蒂角膜瓣,用Ｋｅｒａｔｏｍ Ⅱ准分子激光仪对左眼角膜基质床行预期矫正度数为＋５．００Ｄ、右眼＋８．００Ｄ的激光切削,分别于术前、术后３ 天、２ 周、１ 月、２ 月、３ 月对术眼进行了角膜地形图和裂隙灯检查和记录,同期随机处死一只兔子,取角膜标本进行光镜和电镜的病理学观察。结果：裂隙灯检查所有术眼无严重并发症,＋ ５．００Ｄ组和＋８．００Ｄ组术后３ 个月时的平均角膜中央屈折力变化分别是＋４ ．５２±１．０３Ｄ和＋８．６４±０．８４Ｄ,散光较术前增加０．３６Ｄ 和０ ．８４Ｄ。两组都在术后２ 周～１ 个月时出现回退（ Ｐ＜ ０．０１） 。术后１ 月～３ 月的平均角膜屈折力的差别无统计学意义（ Ｐ＜ ０．０５） 。与预期的光学区直径５．５ｍｍ 相比,两组实际得到的平均光学区直径只有３．９１ｍｍ 和３ ．９３ｍｍ 。实验表明双区域切削方式同样可以应用于ＬＡＳＩＫ治疗高度近视。病理学观察表明病理损伤后的愈合过程与ＬＡＳＩＫ 治疗近视相近。结论：ＬＡＳＩＫ治疗中、高度远视有明显疗效且具     

Laser in situ keratomileusis for hyperopia and hyperopic and mixed astigmatism with LADARVision using 7 to 10-mm ablation diameters

PURPOSE: To evaluate the results of laser in situ keratomileusis (LASIK) performed to correct hyperopia, and hyperopic and mixed astigmatism using wider ablation diameters (optical zone diameter and overall ablation diameter) than those commonly used with the same and other lasers. METHODS: After flap creation using an Alcon SKBM microkeratome set for a 10-mm flap diameter, 53 eyes (33 patients) with a mean spheroequivalent attempted correction of +2.34 +/- 2.09 D underwent LASIK (Alcon LADARVision 4000) using a 7-mm optical zone diameter and a 3-mm transition zone for an overall 10-mm total ablation diameter. The nasal hinge was prevented from undesired ablation by the use of proprietary hinge protector software. Eyes were followed for 6 months after surgery. RESULTS: Six months after surgery, mean spheical equivalent refractive error was -0.22 +/- 0.41 D. There were 79.2% of eyes within +/- 0.50 D, and 98.1% within +/- 1.00 D of intended correction. Uncorrected visual acuity of 20/20 or better was achieved by 28 eyes (53%) and 20/40 or better by 50 eyes (94.3%). No meaningful visual complaints during nighttime hours, such as haloes or glare, were subjectively reported by patients. CONCLUSION: The use of larger ablation diameters in LASIK for hyperopia, and hyperopic and mixed astigmatism produced accurate results, early refractive stability, and good visual performance.     

Pupil center shift relative to the coaxially sighted corneal light reflex under natural and pharmacologically dilated conditions

PURPOSE: To evaluate the location and shift of the pupil center relative to the coaxially sighted corneal reflex on horizontal and vertical planes under natural and pharmacologically dilated conditions. METHODS: Ninety-four (64 myopic and 30 hyperopic) eyes of 47 patients underwent pupillometry with the NIDEK OPD-Scan under photopic and mesopic conditions before and after instillation of cyclopentolate 1%. Horizontal, vertical, and vectorial shift of the pupil center were calculated between each condition. RESULTS: The pupil center was located temporally to the coaxially sighted corneal reflex a mean distance of 0.336 +/- 0.181, 0.345 +/- 0.195, and 0.339 +/- 0.170 mm under photopic, mesopic, and pharmacologically dilated conditions, respectively. The pupil center shifted primarily inferotemporally (44%), followed by inferonasally (22%), superotemporally (19%), and superonasally (15%) from photopic to pharmacologic dilation. Mean magnitude of pupil shift was 0.084 +/- 0.069 mm (range: 0.010 to 0.385 mm) from mesopic to photopic, 0.149 +/- 0.080 mm (range: 0.013 to 0.384 mm) from photopic to pharmacologic dilation, and 0.102 +/- 0.104 mm (range: 0 to 0.530 mm) from mesopic to pharmacologic dilation. Mean distance between the pupil center and the coaxially sighted corneal reflex was greater in hyperopes than in myopes (P < .05), but no significant difference was observed in pupil center shifts between myopes and hyperopes under all three conditions (P > .05). CONCLUSIONS: The pupil center is located temporally and shifts in every direction, primarily inferotemporally, relative to the coaxially sighted corneal reflex with natural and pharmacologic dilation. The horizontal distance between the pupil center and the coaxially sighted corneal reflex was significantly higher in hyperopes than in myopes.     

Comparison of visual effects of FS-LASIK for myopia centered on the coaxially sighted corneal light reflex or the line of sight

AIM: To compare visual quality after femtosecond laser in situ keratomileusis (FS-LASIK), between the coaxially sighted corneal light reflex (CSCLR) group and conventional ablation line of sight (LOS) group. METHODS: In total, 243 eyes (122 patients) were treated with centration on the CSCLR (visual axis) and 238 eyes (119 patients) treated with centration on the pupil center (LOS). Postoperative outcomes [uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA)], safety index, efficacy index, refractive outcome, ablation center distance from the visual axis, corneal high-order aberrations, subjective discomfort glare and shadowing incidence rate, and contrast sensitivity at 1, 3, and 6mo were measured and compared. RESULTS: The mean age was 27.77±7.1y in the CSCLR group and 26.03±7.70y in the LOS group. Preoperatively, the manifest refraction spherical equivalent (MRSE) was -6.68±2.60 D in the CSCLR group and -6.65±2.68 D in the LOS group. The postoperative UCVA, BSCVA, MRSE (-0.03±0.263 D in the CSCLR group, -0.05±0.265 D in the LOS group), efficacy index (1.04, 1.03), and safety index (1.09, 1.08) were not significantly different between the groups (all P>0.05). In total, 3% lost one line and more of BSCVA in the CSCLR group, as 9% in the LOS group postoperatively (P<0.05). The ablation center deviation was 0.20±0.15 mm from the visual axis (Pentacam system default setting; range, 0-0.75 mm) in the CSCLR group, and 0.43±0.22 mm (range, 0-1.32 mm) in the LOS group (P<0.0001). Statistically significant greater augmentation of total corneal higher-order aberrations (0.15±0.10 µm and 0.20±0.12 µm respectively, P=0.03) and vertical and horizontal coma (P<0.0001) were noted in the LOS group. Subjective discomfort glare and shadowing incidence rates were 8.59% and 17.5% in the CSCLR and LOS groups, respectively (P<0.05). The 1-month postoperative contrast sensitivity visual acuity in the CSCLR group was significantly higher than that in the LOS group on contrast (100%, 25%, 10%) with a dark background, but there was no significant difference between the groups at 3 or 6m. CONCLUSION: Myopic LASIK centered on the CSCLR achieves significantly lower induction of loss of BSCVA, corneal high-order aberrations, and lower risk of subjective discomfort glare and shadowing, and lower decline in early contrast sensitivity by comparison with centration on the LOS, giving advantages in visual quality postoperatively.     

Laser in situ keratomileusis for recurrent hyperopia following laser thermal keratoplasty

PURPOSE: Laser thermal keratoplasty (LTK) has its main indication in the correction of hyperopia. However, regression of refractive effect following LTK is a limitation. Laser in situ keratomileusis (LASIK) may provide a good alternative to correct residual refractive errors. METHODS: Fifty hyperopic eyes with varying amounts of regression after LTK underwent LASIK. The Chiron Automated Corneal Shaper microkeratome was used to make a flap of 160 microm and laser ablation was performed with the Technolas 217 Planoscan excimer laser. Postoperative follow-up was 6 months. RESULTS: Mean spherical equivalent refraction improved from +2.92+/-1.60 D to +0.36+/-1.48 D. Mean best spectacle-corrected visual acuity changed from 0.78+/-0.14 before LASIK to 0.76+/-0.16 D 6 months after LASIK. Mean uncorrected visual acuity changed from 0.37+/-0.16 to 0.66+/-0.24. Forty-two percent (21 eyes) were within +/-0.50 D of intended correction, 60% (30 eyes) were within +/-1.00 D, and 76% (38 eyes) were within +/-2.00 D. After LASIK, confluent haze between previous LTK spots was observed in most eyes, as LASIK ablation took place at the sites of the LTK spots. CONCLUSIONS: LASIK after LTK is a good alternative for hyperopic regression. Predictability and efficacy are less than with primary LASIK for hyperopia, but the procedure is equally safe.     

Coaxially sighted intraocular lens light reflex for centration of the multifocal single piece intraocular lens

Centration of multifocal Intraocular lenses (IOL) may be critical to ensure optimal function and prevent untoward side effects. Pharmacologic pupillary dilation and constriction may shift the physiologic location of the pupillary center rendering intraoperative positioning of multifocal IOL challenging. Similarly, the anterior capsular center is difficult to pinpoint and may not correspond to either the visual axis or the pupillary center. The visual axis is the only landmark that can be consistently identified prior, during and after cataract surgery. Centering diffractive multifocal IOL on the visual axis may allow more consistent placement and better outcome measures. In the following, we describe a simple technique to center multifocal single piece acrylic IOLs on the visual axis.     

Anterior corneal optical aberrations induced by laser in situ keratomileusis for hyperopia

PURPOSE: To evaluate the effects of hyperopic laser in situ keratomileusis (LASIK) on anterior corneal higher-order aberrations (HOAs) (3rd to 6th orders). SETTING: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS: In a retrospective study, 3rd-order to 6th-order HOAs from preoperative and 3-month postoperative corneal topographic maps of eyes that had hyperopic LASIK using the Visx Star S2 and Visx Star S3 laser systems were calculated. There were 20 eyes of 14 patients in each group; the optical and transition zones were 6.0 mm and 9.0 mm, respectively. The surgically induced changes in anterior corneal HOAs and the differences between the HOA changes in corneas treated with and without active eye tracking were analyzed. RESULTS: In both groups, hyperopic LASIK induced a significant reduction in 4th-order spherical aberration (SA) coefficients (Z4(0)) in the 3.0 mm and the 6.0 mm central zones, and the decrease was significantly correlated with increasing hyperopic correction (except in the Visx S3 group's central 3.0 mm zone). In the 6.0 mm zone in both groups, the root-mean-square (RMS) of the SA (Z4(0) and Z6(0)) decreased significantly, whereas there were no significant changes in the total HOAs. By excluding Z4(0), the mean RMS values for the remaining 21 Zernike terms increased by more than 30% (both P<.016). A simulated increase in pupil size from 3.0 to 6.0 mm caused a significantly smaller increase in SA in postoperative corneas compared to the preoperative values. Differences between the S2 and S3 groups were minimal. CONCLUSIONS: Hyperopic LASIK decreased SAs and reduced the magnitude of the SA increase that occurred with pupil dilation. Higher-order aberrations excluding the 4th-order SA increased significantly.     

准分子激光原位角膜磨镶术治疗远视眼

目的 :评价LASIK治疗远视眼的有效性、可预测性和安全性。方法 :用LASIK治疗 54只远视眼 ,屈光度 1 0 0～ 6 0 0D ,术后平均随访一年。对裸眼和矫正视力、屈光稳定性和并发症等进行了分析。结果 :至术后一年时 ,平均残余屈光度为 0 2 9± 0 78D ,屈光度在± 0 5D和± 1 0D以内者分别占 61 1 % ( 33只眼 )和 83 3% ( 45只眼 )。裸眼视力达到 0 5以上者占 92 6% ( 50只眼 ) ,1 0以上者 63 0 % ( 34只眼 )。 1只眼 ( 1 9% )最佳矫正视力下降 2行 ,2只眼 ( 3 7% )增加 2行。 2只眼 ( 3 7% )有眩光。结论 :LASIK可用于治疗 1 0 0～ 6 0 0D的远视眼且具有较好的预测性和安全性。对手术技术和激光治疗程序的不断改进将有助于进一步提高手术的可预测性和稳定性     

Laser in situ keratomileusis enhancement for consecutive hyperopia after myopic overcorrection.

PURPOSE: To assess the efficacy, predictability, and safety of laser in situ keratomileusis (LASIK) for the treatment of consecutive hyperopia after myopic LASIK. SETTING: Stanford University School of Medicine, Stanford, California, USA. METHODS: In a retrospective study, 36 eyes of 30 patients with consecutive hyperopia after myopic LASIK had LASIK retreatment using the VISX S2 excimer laser. Primary outcome variables including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, complications, and vector analysis were evaluated preoperatively and 1 day and 3 months postoperatively. RESULTS: The mean spherical equivalent decreased from +1.52 diopters (D) +/- 0.55 (SD) (range +0.63 to +2.63 D) preoperatively to -0.10 +/- 0.52 D (range -1.25 to +1.50 D) 3 months after retreatment. The UCVA was 20/20 or better in 24 eyes (66.7%) and 20/40 or better in 34 eyes (94.4%). Twenty eyes (55.5%) were within +/-0.5 D of the intended correction and 34 eyes (94.4%), within +/-1.0 D. No eye lost 2 or more lines of BSCVA. One eye (2.8%) developed diffuse lamellar keratitis that resolved without sequelae, and 2 eyes (5.6%) developed nonprogressive epithelial ingrowth that did not require removal. CONCLUSIONS: Laser in situ keratomileusis retreatment for consecutive hyperopia following myopic LASIK was an effective, predictable, and safe procedure. Long-term follow-up is needed to assess stability.     

准分子激光原位角膜磨镶术治疗远视

目的　评价准分子激光原位角膜磨镶术 (LASIK)治疗的效果和安全性。方法　对 16例 ( 3 0眼 )远视行LASIK。术前远视度数为 3 5 0～ 12 .5D ,平均 ( 7 0 9± 2 .62 )D。术后随访观察 12月。结果　术中无严重并发症 ,术后 3月屈光度基本稳定 ,术后 12月残余屈光度在 1 0 0D和 2 0 0D以内的分别占 40 0 0 % ( 12眼 )和 63 3 3 % ( 19眼 ) ,裸眼近视力≥ 0 .5者 3 0眼 ( 10 0 0 0 % ) ,≥ 1 0者 2 4眼 ( 80 0 0 % ) ,裸眼远视力≥ 0 .5者 2 6眼 ( 86 67% ) ,≥ 1.0者 9眼 ( 3 0 0 0 % ) ,1眼 ( 3 3 3 % )最佳矫正视力下降一行 ,5眼 ( 16 67% )有眩光。结论　LASIK治疗远视安全有效。治疗软件进一步完善及治疗参数进一步的调整将有助于提高手术的可预测性和稳定性     

Comparison of LADARVision and Visx Star S3 laser in situ keratomileusis outcomes in myopia and hyperopia

PURPOSE: To compare visual outcomes with 2 commonly used excimer lasers, the Autonomous LADARVision (LV) (Alcon Laboratories Inc.) and the Visx Star S3 (S3), in the performance of myopic and hyperopic astigmatic laser in situ keratomileusis (LASIK). SETTING: Zale Lipshy University Hospital Laser Center for Vision, University of Texas Southwestern Medical Center, Dallas, Texas, USA. METHODS: In this retrospective single-center 3-surgeon cohort comparison, 100 consecutive LV-treated myopic eyes with a mean manifest refraction spherical equivalent (MRSE) of -3.22 diopters (D) (range 0 to -6.00 D) (mean astigmatism 0.95 D [range 0 to 4.00 D]) were compared with 100 consecutive S3-treated eyes with a similar MRSE (mean MRSE -3.19 D; mean astigmatism 0.66 D [range 0 to 2.75 D]). Forty-one consecutive LV-treated hyperopic eyes with a mean MRSE of +2.59 D (range +1.00 to +6.00 D) (mean astigmatism 0.89 D [range 0 to 3.50 D]) were compared with 25 consecutive S3-treated eyes with a similar MRSE (mean MRSE +2.70 D; mean astigmatism 0.87 D [range 0 to 2.75 D]). The following outcomes were compared: uncorrected visual acuity, refractive predictability and stability, gain or loss of best spectacle-corrected visual acuity, and need for enhancement. RESULTS: Statistically significant differences in outcomes were found between lasers in the treatment of hyperopia and hyperopic astigmatism. No outcome differences between lasers were found in the treatment of myopia and myopic astigmatism. CONCLUSION: The LV and S3 lasers yielded equivalent results in myopic LASIK between 0 and -6.00 D; however, the LADARVision yielded statistically significantly better results in hyperopic LASIK between +1.00 and +6.00 D.     

Total and corneal optical aberrations induced by laser in situ keratomileusis for hyperopia

PURPOSE: To evaluate changes induced by standard laser in situ keratomileusis (LASIK) for hyperopia on total and corneal optical quality. METHODS: Total and corneal aberrations were measured before and after standard hyperopic LASIK in 13 eyes (preoperative spherical equivalent refractive error +3.17 +/- 1.10 D). The Chiron Technolas 217C laser with PlanoScan was used. Total aberrations (measured using laser ray tracing) and corneal aberrations (estimated from a videokeratoscope) were described using Zernike terms. Root-mean-square wavefront error for both total and corneal aberrations, and through-focus Strehl ratio for the point spread function of the whole eye were used to assess optical changes induced by surgery. RESULTS: Third and higher order aberrations increased significantly after hyperopic LASIK (by a factor of 2.20 for total and 1.78 for corneal aberrations, for a 6.5-mm pupil). Spherical aberration changed to negative values (corneal average decreased by -0.85 +/- 0.48 microm and total average by -0.70 +/- 0.30 microm). Best Strehl ratio for the whole eye decreased by a factor of 1.84. Hyperopic LASIK induced larger changes than myopic LASIK, compared to an equivalent group of myopic eyes from a previous study. Induced corneal spherical aberration was six times larger after hyperopic LASIK, for a similar range of correction, and of opposite sign. As with myopic LASIK, changes in internal spherical aberration are of opposite sign to those induced on the corneal anterior surface. CONCLUSIONS: Hyperopic LASIK induced significant amounts of aberrations. The largest increase occurred in spherical aberration, which showed a shift (toward negative values) of opposite sign; increase was greater than for myopic LASIK.     

Laser in situ keratomileusis for consecutive hyperopia after myopic LASIK and radial keratotomy

PURPOSE: To evaluate and compare the efficacy, predictability, and safety of hyperopic laser in situ keratomileusis (H-LASIK) for the correction of consecutive hyperopia after myopic-LASIK (M-LASIK) and radial keratotomy (RK). SETTING: The Eye Institute of Utah, Salt Lake City, Utah, USA. METHODS: Seventy-seven eyes of 64 patients were studied. The eyes were divided into 2 groups based on the prior refractive procedures: in Group A (n = 34), H-LASIK was performed for overcorrection after M-LASIK and in Group B (n = 43), for overcorrection after RK. All eyes were included in the analysis of intraoperative and postoperative complications. Only eyes with a minimum follow-up of 6 months were included in the analysis of visual and refractive results. Among these 66 eyes, 30 were in Group A and 36 were in Group B. The mean follow-up in these eyes was 12.34 months +/- 5.95 (SD) (range 6 to 33 months). RESULTS: Overall, the mean spherical equivalent (SE) was +1.88 +/- 0.91 diopters (D) preoperatively and -0.37 +/- 0.65 D at the last visit. Eighty-three percent of eyes were within +/-1.00 D of emmetropia, and 66% were within +/-0.50 D. The uncorrected visual acuity (UCVA) was 20/20 in 39% of eyes and 20/40 or better in 92% of eyes. The preoperative SE was +1.43 +/- 0.59 D in Group A and +2.26 +/- 0.96 D in Group B; the difference in the preoperative SE was significant (P=.001). However, there was no statistically significant between-group difference in postoperative refraction and UCVA. One eye in Group B (3%) lost 2 or more lines of best corrected visual acuity. Corneal ectasia developed in 1 eye in Group B 11 months after H-LASIK. A sliver occurred in 1 eye in Group A after the flap was recut. CONCLUSION: Hyperopic LASIK was equally effective and predictable in treating consecutive hyperopia after overcorrected M-LASIK and overcorrected RK. The safety of the procedure in the RK group appeared to be inferior to that in the M-LASIK group. Although vision-threatening complications are rare after H-LASIK retreatment, corneal ectasia developed in 1 eye in the RK group.     

Laser in situ keratomileusis for correction of hyperopia and hyperopic astigmatism with the Technolas 117C

PURPOSE: To evaluate the effectiveness, predictability, and safety of laser in situ keratomileusis (LASIK) for correction of hyperopia and hyperopic astigmatism. METHODS: Fifty-four hyperopic eyes of 35 patients with a spherical equivalent refraction between +1.00 and +6.00 D were followed for at least 12 months following LASIK. All surgery was performed with the scanning Chiron Technolas Keracor 117C excimer laser. Data on uncorrected and spectacle-corrected visual acuity, predictability, stability of refraction, and complications were analyzed. RESULTS: At 12 months, the average residual refraction was +0.29 +/- 0.78 D; 83.3% of eyes (45 eyes) were in the range of +/- 1.00 D and 61.1% of eyes (33 eyes) were within +/- 0.50 D of emmetropia. Fifty eyes (92.6%) had uncorrected visual acuity of 20/40 or better and 34 (63.0%) eyes had 20/20 or better. One eye (1.9%) lost two lines of best spectacle-corrected visual acuity and two eyes (3.7%) gained two or more lines. Two patients (two eyes, 3.7%) had complaints of halos and one patient (one eye, 1.9%) had glare at 12 months after LASIK for hyperopia. CONCLUSIONS: LASIK was used to treat hyperopia from +1.00 to +6.00 D with good predictability and safety. Primary and second hyperopia require different nomograms, according to our experience.