LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism

A report by the American Academy of Ophthalmology

Gary A. Varley, David Huang, Christopher J. Rapuano, Steven Schallhorn, Brian S. Boxer Wachler, Alan Sugar

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Objective To describe LASIK for hyperopia, hyperopia with astigmatism, and mixed astigmatism and to examine the evidence to answer questions about the safety and efficacy of the procedure. Methods A literature search conducted for the years 1968 to 2002 retrieved 118 citations. During review and preparation of this article, an additional 2 articles were included. The panel members selected 36 articles for the panel methodologist to review and rate according to the strength of evidence. A level I rating is assigned to properly conducted, well-designed, randomized clinical trials; a level II rating to well-designed cohort and case-control studies; and a level III rating to case series, case reports, and poorly designed prospective and retrospective studies. Results This assessment describes 5 nonrandomized interventional trials (level II), 3 nonrandomized comparative trials (level III), and 20 noncomparative case series (level III). Additionally, 6 single-case reports (level III) were included because they reported relevant complications, and 2 theoretical analyses (level III) were also considered. This assessment does not compare studies because many variables such as range of hyperopia, follow-up periods, lasers, microkeratomes, techniques, and surgeon experience have not been controlled. Conclusions For low (4 to 5 D). Utilizing hyperopic LASIK for the treatment of consecutive hyperopia and astigmatism is also effective, although the ability to reduce hyperopic astigmatism after radial keratotomy is limited. Although a variety of ablation profiles can be used to treat mixed astigmatism, very good visual results have been reported (levels II and III evidence). Serious adverse complications leading to permanent visual loss are possible but, fortunately, very rare. There are insufficient data to compare one laser system with another or one ablation profile with another.

Original languageEnglish (US)
Pages (from-to)1604-1617
Number of pages14
JournalOphthalmology
Volume111
Issue number8
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Hyperopia
Laser In Situ Keratomileusis
Astigmatism
Lasers
Radial Keratotomy
Case-Control Studies
Randomized Controlled Trials
Retrospective Studies
Prospective Studies
Safety

ASJC Scopus subject areas

  • Ophthalmology

Cite this

LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism : A report by the American Academy of Ophthalmology. / Varley, Gary A.; Huang, David; Rapuano, Christopher J.; Schallhorn, Steven; Boxer Wachler, Brian S.; Sugar, Alan.

In: Ophthalmology, Vol. 111, No. 8, 08.2004, p. 1604-1617.

Research output: Contribution to journalArticle

Varley, Gary A. ; Huang, David ; Rapuano, Christopher J. ; Schallhorn, Steven ; Boxer Wachler, Brian S. ; Sugar, Alan. / LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism : A report by the American Academy of Ophthalmology. In: Ophthalmology. 2004 ; Vol. 111, No. 8. pp. 1604-1617.
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abstract = "Objective To describe LASIK for hyperopia, hyperopia with astigmatism, and mixed astigmatism and to examine the evidence to answer questions about the safety and efficacy of the procedure. Methods A literature search conducted for the years 1968 to 2002 retrieved 118 citations. During review and preparation of this article, an additional 2 articles were included. The panel members selected 36 articles for the panel methodologist to review and rate according to the strength of evidence. A level I rating is assigned to properly conducted, well-designed, randomized clinical trials; a level II rating to well-designed cohort and case-control studies; and a level III rating to case series, case reports, and poorly designed prospective and retrospective studies. Results This assessment describes 5 nonrandomized interventional trials (level II), 3 nonrandomized comparative trials (level III), and 20 noncomparative case series (level III). Additionally, 6 single-case reports (level III) were included because they reported relevant complications, and 2 theoretical analyses (level III) were also considered. This assessment does not compare studies because many variables such as range of hyperopia, follow-up periods, lasers, microkeratomes, techniques, and surgeon experience have not been controlled. Conclusions For low (4 to 5 D). Utilizing hyperopic LASIK for the treatment of consecutive hyperopia and astigmatism is also effective, although the ability to reduce hyperopic astigmatism after radial keratotomy is limited. Although a variety of ablation profiles can be used to treat mixed astigmatism, very good visual results have been reported (levels II and III evidence). Serious adverse complications leading to permanent visual loss are possible but, fortunately, very rare. There are insufficient data to compare one laser system with another or one ablation profile with another.",
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