Visual Outcomes After Wavefront-guided Laser in situ Keratomileusis With and Without Iris Registration in Hyperopia

Abstract

Purpose: : To evaluate and compare the efficacy, safety, predictability of wavefront-guided laser in situ keratomileusis (LASIK) in hyperopic patients in which iris registration (IR) was used and eyes in which iris registration would not engage (no-IR group) at 3 and 6 months.

Methods: : This retrospective study included 58 eyes of 31 patients with primary hyperopia or hyperopic astigmatism. Twenty- two eyes were in the IR group and 36 in the no -IR group. Both had comparable baseline characteristics. The mean preoperative spherical equivalent was 1.69±0.84 D and 1.81±0.72 D in IR and no-IR group respectively (P = 0.876). All eyes were done using the Visx Custom Vue S4 IR platform (Advanced Medical Optics). Safety, efficacy, predictability and need for enhancement were compared in both groups at 3 and 6 months.

Results: : Safety was evaluated at 3 months. There was 73% in the IR 83% in no-IR group that had the same best spectacle-corrected visual acuity (BSCVA) as preoperatively or had gained 1 or 2 lines of BSCVA. No eye in either group lost more than 1 line of BCVA (P = 0.505).Efficacy was also evaluated at 3 months. There was 45% in the IR and 61% in the no-IR group that had the same uncorrected visual acuity (UCVA) as preoperatively or had gained 1 or 2 lines of UCVA. No eye in either group lost more than 1 line of UCVA (P = 0.285). No enhancements were performed.Safety was evaluated at 6 months. There was 91% in the IR group and 86% in the no-IR group that had the same BSCVA as preoperatively or had gained 1 or 2 lines of BSCVA. No eye in either group lost more than 1 line of BCVA (P = 1.000).Efficacy was also evaluated at 6 months. There was 68% in the IR and 72% in the no-IR group that had the same UCVA as preoperatively or had gained 1 or 2 lines of UCVA. No eye in either group lost more than 1 line of UCVA (P = 1.000). Enhancements were done in 9% in the IR and 4% in the no-IR group.

Conclusions: : The results in both the IR and no-IR hyperopic patients were comparable with good refractive measured outcomes at both 3 and 6 month follow-ups. There were no statistically significant differences between both groups.

Keywords: refractive surgery: LASIK • hyperopia • refractive surgery: comparative studies