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Femtosecond LASIK effective for post-RK hyperopia in study

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Performing LASIK using a femtosecond laser for flap creation can effectively treat secondary hyperopia resulting from previous RK, a small prospective study showed. However, the procedure should be avoided in eyes with more than eight RK incisions due to an increased complication risk, the study authors noted.

Gonzalo Muñoz, MD, PhD, FEBO, and colleagues in Valencia, Spain, evaluated outcomes of 13 eyes of nine patients treated for secondary hyperopia after previously undergoing RK. In all cases, surgeons used the IntraLase FS femtosecond laser (Advanced Medical Optics) to create the corneal flaps, which averaged 117 ± 14 µm in thickness and 9.18 ± 0.12 mm in diameter.

The researchers found that spherical equivalent had decreased from an average of 2 D preoperatively to –0.41 D at 6 months follow-up, and eight eyes (61.5%) were within 0.5 D of target refraction, according to the study.

Also at 6 months, 12 eyes (92.3%) had at least 20/40 uncorrected visual acuity and only three eyes (23.1%) had lost one line of best corrected visual acuity, the authors reported.

"Most complications were in eyes with more than eight RK incisions than in eyes with eight RK incisions," they said.

All eyes with more than eight RK incisions developed intraoperative incision openings, 66.6% experienced interface inflammation, 83.3% developed haze and 50% had a loss of BCVA.

In contrast, among eyes with eight RK incisions, only 28.6% developed intraoperative incision openings, 14.3% developed haze and none experienced interface inflammation or a loss of BCVA, according to the study.

"The femtosecond laser provided large, thin corneal flaps for hyperopic LASIK. However, the procedure should be avoided in eyes with more than eight RK incisions because of the increased risk for multiple intraoperative incision openings, interface inflammation, haze and loss of BCVA," the authors said.

The study is published in the July issue of Journal of Cataract and Refractive Surgery.