High hyperopic LASIK with reduction of corneal prolateness to control induced spherical aberration

Imene Salah-Mabed; Guillaume Debellemanière; Radhika Rampat; Mathieu Dubois; Damien Gatinel

doi:10.1097/j.jcrs.0000000000001475

High hyperopic LASIK with reduction of corneal prolateness to control induced spherical aberration

J Cataract Refract Surg. 2024 May 15. doi: 10.1097/j.jcrs.0000000000001475. Online ahead of print.

Authors

Imene Salah-Mabed¹, Guillaume Debellemanière, Radhika Rampat, Mathieu Dubois, Damien Gatinel

Affiliation

¹ Department of Anterior Segment and Refractive Surgery, Rothschild Foundation, Paris, France.

PMID: 38758195
DOI: 10.1097/j.jcrs.0000000000001475

Abstract

Purpose: To evaluate visual outcomes of high hyperopic LASIK, using corneal aspherization to control the induced spherical aberration.

Setting: Fondation Ophtalmologique Adolphe de Rothschild.

Design: Prospective interventional case series.

Methods: Prospective interventional study of consecutive high hyperopes (≥+3D of Spherical Equivalent SE) undergoing LASIK with the WaveLight FS200 femtosecond and EX500 excimer laser platform. An aspheric ablation profile (planned change in corneal asphericity ΔQ = +0.2) was delivered using the Custom-Q nomogram (Alcon Laboratories, Inc., Fort Worth, TX) on an optical zone of ≥ 6.5mm centered near the corneal vertex. Uncorrected and best-corrected distance visual acuity (UDVA-BDVA), as well as changes in SE, corneal asphericity (ΔQ) and Higher order aberrations (HOAs), were analyzed preoperatively and on day1, 1, 3, 6, and 12 months.

Results: 117 eyes of 63 patients, (mean age of 30.1 ± 5.6 years), were included. Preoperatively and at 12 months postoperatively, the mean SE was 5.1 ± 1.1 D and 0.00 ± 0.7 D, respectively. 88% of eyes achieved 0 Log Mar or better UDVA at 12 months. One month after surgery, there was a statistically significant induction of positive spherical aberration decreasing progressively and significantly until the last visit (Preop SA4 = 0.09 ± 0.11 µm, Day 1 SA4 = 0.30 ± 0.32 µm, 12 Months SA4 = 0.08 ± 0.21 µm, p=0.056). Two eyes needed enhancement at 12 months.

Conclusion: LASIK for high levels of hyperopia showed good outcomes mainly due to aspheric-customized ablation profile with a change of ΔQ = +0.2 in corneal asphericity.