Femtosecond laser–assisted hyperopic laser in situ keratomileusis with tissue-saving ablation: Analysis of 800 eyes

PURPOSE: To evaluate the results and complications of hyperopic laser in situ keratomileusis (LASIK) with a low-energy femtosecond laser and non-custom tissue-saving ablation profile. SETTING: Private practice, Siena, Italy. DESIGN: Case series. METHODS: Hyperopic eyes with a spherical equivalent (SE) between +1.0 and +6.5 diopters (D) had LASIK. The flap (nominal thickness 110 μm) was created with a Ziemer LDV Z2 femtosecond laser and the refractive ablation performed with a Technolas 217P excimer laser in tissue-saving mode. RESULTS: Eight hundred eyes of 413 patients were treated. The mean preoperative values were SE, +3.41 D ± 1.16 (SD); defocus equivalent, 4.20 ± 1.33; corrected distance visual acuity (CDVA), 0.07 ± 0.08 logMAR. At 9 months, the mean SE was -0.06 ± 0.26 D and the mean defocus equivalent 0.68 ± 0.62 (both P<.05). The defocus equivalent was 0.50 D or less in 594 eyes (74.3%) and 1.00 D or less in 707 eyes (88.4%). The mean CDVA was 0.07 ± 0.06 logMAR; 3 eyes (0.4%) lost 2 lines of CDVA and 58 eyes (7.3%) lost 1 line. The mean uncorrected distance visual acuity was 0.16 ± 0.13 logMAR. The safety index was 1.0 and the efficacy index, 0.8. The mean root-mean-square induced primary spherical aberration was 0.65 μm and the mean induced primary coma, 0.24 μm (both P<.05). CONCLUSIONS: The low incidence of femtosecond-related complications was associated with good predictability, safety, and a low retreatment rate. The mean flap was 7 μm thicker than expected. FINANCIAL DISCLOSURES: The author has no financial or proprietary interest in any material or method mentioned.