So say researchers at Stanford University School of Medicine (Palo Alto, Calif.) who recently evaluated the long-term effectiveness and stability of conductive keratoplasty for the correction of low to moderate hyperopia.

Conductive keratoplasty and hyperopia: Study design and methods

The researchers evaluated the refractive outcomes of 16 eyes of nine farsighted subjects who had their vision corrected with CK between 1999 and 2000.

Prior to surgery, the mean spectacle refraction of these patients was +1.45 diopters (D) of hyperopia.

The mean follow-up period for eyes in the study was 73 months (6 years, 1 month).

Conductive keratoplasty and hyperopia: Results

Results of the study included:

• At 23 months after the CK eye surgery, the mean refractive error was +0.295 D (20 percent of the mean refractive error present prior to surgery).
• At 48 months after surgery, the mean refractive error was +1.00 D (69 percent of the mean pre-operative refractive error).
• At the final follow-up visit (a mean of 73 months after surgery), the mean refractive error was +1.394 D (96 percent of the mean refractive error present prior to surgery).

No eye lost more than one line of best corrected visual acuity as a result of the conductive keratoplasty procedure.

Conductive keratoplasty and hyperopia: Conclusions

The researchers concluded that while conductive keratoplasty is safe and effective for the correction of low to moderate hyperopia, a significant regression of farsightedness takes place over time after surgery.

Prospective refractive surgery patients should be counseled that the effects of CK for the correction of farsightedness are not permanent, they said.

SOURCE:  Regression of effect over long-term follow-up of conductive keratoplasty to correct mild to moderate hyperopia. Journal of Cataract & Refractive Surgery. September 2009.

In 2008, Optical Express, the largest provider of laser vision correction in Europe established an online interactive survey of patients who received LASIK or LASEK at Optical Express locations to evaluate the quality of care provided, how well patient expectations were met, and the level of patient satisfaction, according to the company.

At one month after surgery, 13,655 patients completed the survey. Of the respondents, 91 percent had undergone LASIK and 9 percent had undergone LASEK.

Treatments ranged from the correction of up to -11.63 diopters (D) of myopia to up to +6.00 D of hyperopia. The mean spherical equivalent of all laser vision correction procedures was -2.27 D of myopia.

Patients ranged in age from 18 to 71 years, with an average age of 39.4 years.

Laser vision correction survey: One-month results

Results of the surveys completed one month after surgery by this large group of patients revealed:

• 95 percent said they were either “very satisfied” (77.8 percent) or “satisfied” (17.2 percent) with their vision after laser vision correction.
• 74.7 percent said their vision was better than they expected it would be. (19.4 percent said it was equal to their expectations and 5.9 percent said it was worse than what they expected prior to surgery.)
• 82.8 percent said their vision ws better after laser vision correction than it was with glasses or contact lenses prior to surgery.
• 94.2 percent said laser vision correction had changed their life for the better.
• 96.5 percent said they would recommend laser vision correction procedures, such as LASIK, LASEK, Presby-LASIK and PRK eye surgery, to their friends and family.

Conclusions

The researchers concluded the results of the survey show modern laser vision correction surgery by a large corporate provider produces a high level of patient satisfaction.

Regarding limitations of the study, the researchers noted that only 43 percent of 31,979 patients who attended their one-month follow-up visit after LASIK or LASEK completed the online survey.

A comparison of patients who completed the survey and those that did not, however, found no differences in most-pre-operative characteristics.

The researchers said that although the differences between those who completed the survey and those who did not “are unlikely to have true clinical relevance,” it is possible that the patients who completed the survey were selectively more satisfied or less satisfied than those who did not.

SOURCE:  Satisfaction of 13,655 patients with laser vision correction at 1 month after surgery. Journal of Refractive Surgery. July 2009. (Supplement: Clinical Outcomes and Quality of Care in Refractive Surgery, sponsored by Optical Express.)

LASIK for hyperopia: Study design

The study evaluated the results of LASIK surgery on two groups of patients with hyperopia: Group 1 consisted of patients with up to 3.50 D of farsightedness and Group 2 consisted of patients with at least 3.60 D.

All LASIK procedures were performed with a MEL 80-G excimer laser (Carl Zeiss Meditec) and outcomes were monitored for at least one year.

LASIK for hyperopia: Results

At one year after surgery,

• Mean uncorrected visual acuity (UCVA) improved from 20/40 pre-operatively to nearly 20/20 after LASIK in Group 1 and from 20/40 before surgery to 20/25 after LASIK in Group 2.
• Mean spherical equivalent refractive error improved from +2.50 D pre-operatively to +0.10 D after LASIK in Group 1 and from +4.50 D pre-operatively to +0.40 D after LASIK in Group 2.
• 70.9 percent of eyes in Group 1 and 63.3 percent in Group 2 had less than 0.50 D of refractive error (hyperopia or myopia) after surgery.
• 92.8 percent of eyes in Group 1 and 87.8 percent in Group 2 maintained or gained one or more lines of best corrected visual acuity (BCVA) after LASIK.
• 1.7 percent of eyes in Group 1 and 4.0 percent in Group 2 lost two or more lines of BCVA after surgery.
• 20.0 percent of eyes in Group 1 and 18.4 percent in Group 2 required a second (“enhancement”) LASIK surgery to achieve an acceptable visual outcome.

Conclusions

Based on the results of the study, the researchers concluded that excimer laser LASIK is safe and effective for treating hyperopia up to +6.25 D.

Though the rate of enhancement procedures was higher than that noted in studies for the correction of myopia, patients with hyperopia in this study who had enhancements due to loss of best corrected visual acuity experienced no further loss of BCVA after enhancement.

SOURCE:  One-year results of excimer laser in situ keratomileusis for hyperopia. Journal of Cataract & Refractive Surgery. July 2009.