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At least 217 records · Page 12Linked to original sources
PubMed2003

Photorefractive keratectomy versus laser in situ keratomileusis for the treatment of spherical hyperopia.

OBJECTIVE: To compare photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in treating spherical hyperopia using the VISX STAR S2 excimer laser. INTERVENTION: Fifteen consecutive eyes of 15 patients underwent PRK, and 16 consecutive eyes of 16 patients underwent LASIK (follow-up: 12 months). MAIN OUTCOME MEASURES: Postoperative pain, uncorrected visual acuity (UCVA), deviation from intended correction, and loss of best spectacle-corrected visual acuity (BSCVA). RESULTS: Mean preoperative spherical equivalent was + 2.18 diopter [D] for PRK and + 2.03D for LASIK. All PRK patients experienced significant postoperative pain that required systemic medication, whereas LASIK patients had minor and transient discomfort. Mean deviation from intended correction was -0.83D, + 0.01D, and + 0.18D at 1, 6, and 12 months after PRK, and + 0.22D, +0.30D, and + 0.40D at 1, 6, and 12 months after LASIK (P = 0.002 at 1 month). A higher proportion of LASIK eyes had a UCVA of 20/20 or better at all time points (P = 0.013 and 0.025 at 1 and 3 months, respectively). There was no statistically significant difference between both groups in BSCVA loss. CONCLUSIONS: LASIK and PRK are comparable in efficacy and safety. However, PRK was more painful, with an initial and temporary myopic over-correction that did not occur after LASIK. Stability was achieved between 3 and 6 months following PRK, and one month following LASIK.

Cornea↗
PubMed1982

Refractive change in hyperglycaemia: hyperopia, not myopia.

Sudden changes in refraction are well recognised feature of hyperglycaemia. A tendency towards myopia has always been associated with elevations in blood glucose. Twelve diabetic patients were found to have experienced such refractive changes. Review of their records demonstrates that hyperglycaemia produces hyperopia. A theoretical mechanism for this phenomenon is discussed.

Adult↗
PubMedDate not supplied

Changes in deviation following correction of hyperopia in children with fully refractive accommodative esotropia.

Changes in deviation may occur following the correction of hyperopia in children with accommodative esotropia. We analyzed possible factors involving the development of changes in deviation. We examined 49 children (23 boys and 26 girls) who had fully refractive accommodative esotropia at the age of 3 or 4 years. All children wore glasses to correct the fully cycloplegic refractive errors. At the age of 10 or 11 years, 28 (57.1%) of these children had good alignment, 12 (24.5%) developed partial accommodative esotropia and 9 (18.4%) developed consecutive exotropia. The age at onset of esotropia, age at initial visit, and refraction, deviation and presence of stereopsis, as determined by the Titmus test using a fly at the initial visit, were similar among the three groups. In the consecutive exotropia group, amblyopia at the initial visit was significantly higher (89%) than that of the good alignment group (50%). The age at the start of the correction, and the refraction, amblyopia and presence of fusion (10 or 11 years) were almost equal among the three groups. We conclude that some children with fully refractive accommodative esotropia associated with amblyopia at the age of 3 or 4 years may be predisposed to developing consecutive exotropia.

Accommodation, Ocular↗
PubMed1992

High hyperopia with papillomacular fold.

We report a case of evolutive high hyperopia in a child aged 10 years. It is associated with organic amblyopia due to a large papillomacular retinal fold. Ultrasonography and CT scan helped to establish the diagnosis. This is probably a hereditary disease affecting the development of the posterior sclera.

Child↗
PubMedDate not supplied

Correction of hyperopia with non-contact Ho:YAG laser thermal keratoplasty.

PURPOSE: To assess the potential of non-contact holmium:YAG laser thermal keratoplasty to safely and effectively correct hyperopia up to +5.00 diopters (D). METHODS: Non-contact laser thermal keratoplasty with a holmium:YAG laser using energies ranging from 215 to 255 mJ with 6, 7, and 8-min ablation zone diameters, was applied to 57 sighted eyes of 42 hyperopic patients in a controlled study. All patients were followed for 15 months after surgery. RESULTS: Preoperative spectacle-corrected visual acuity returned to baseline levels from 2 to 6 weeks after treatment. Regression of effect was evident in all eyes, and after 15 months was total in 18 eyes (31.5%). The mean cycloplegic refraction before surgery was +3.80 +/- 0.22 D (range, +1.50 to +5.00 D); after surgery, it was +1.40 +/- 0.12 at 3 months, +1.69 +/- 0.19 D at 6 to 8 months, and +1.73 +/- 0.16 D at 15 months. At the end of the study, 41 eyes (71.9%) had an uncorrected visual acuity of 20/40 or better. Thirty-two eyes (58.8%) were within +/- 1.00 D of the intended refraction. Patient age and central pachymetric values were significantly correlated with regression (ANOVA, (p less than .005). CONCLUSIONS: Regression of initial effect can be large with non-contact holmium:YAG laser thermal keratoplasty. We think the technique works best up to +3.00 D in older individuals with central corneal thickness less than 525 microns. Algorithms to improve the final results should include an initial calculated overcorrection adjusted on variables that influence regression such as patient age and corneal thickness.

Adolescent↗
PubMed1997

Laser in situ keratomileusis for hyperopia.

PURPOSE: To study the efficacy of laser in situ keratomileusis (LASIK) for hyperopia. METHODS: We performed LASIK on 21 eyes using the Nidek EC-5000 excimer laser with software version 2.18 AH. The Chiron Automated Corneal Shaper was used to create the flap. Retreatments were needed in seven eyes due to decentration or undercorrection. RESULTS: Although a high rate of satisfaction was noted among patients, complications were encountered such as decentration (three eyes), undercorrection (four eyes); one patient progressed to low myopia with a loss of spectacle-corrected visual acuity and one patient had regression 3 months after the initial LASIK. CONCLUSION: Although this technique has several advantages over other techniques (holmium, ALK, PRK, hexagonal RK), it has a high rate of retreatment and some complications. Software refinement is needed, and patients should be adequately informed about what to expect from this technique.

Adolescent↗
PubMedDate not supplied

Purse-string sutures for hyperopia following radial keratotomy.

BACKGROUND: Five years ago, we presented 19 procedures employing two intrastromal purse-string sutures to treat hyperopic shift following radial keratotomy. Thirty-four additional procedures and longer follow-up are now presented detailing the task of rehabilitating these eyes. METHODS: Fifty-three eyes of 53 radial keratotomy patients who were unhappy with their uncorrected vision and who were dissatisfied with contact lens or spectacle correction underwent double corneal intrastromal purse-string suturing and were subsequently followed for at least 1 year. There were seven eyes with primary overcorrection and 46 eyes with progressive hyperopic shift. Spherical equivalent refraction before purse-string sutures ranged from +0.50 to +6.25 D (mean, +2.60 D, SD +/- 1.26 D). Prior to purse-string suturing, uncorrected visual acuity ranged from 20/30 to 20/400 with 21 eyes (45.3%) 20/100 or worse. RESULTS: The follow-up after suturing averaged 3.6 years (range, 1 to 10 yr). All patients had follow-up of at least 1 year. The steepening in average keratometric power was 2.94 +/- 1.72 D (range, 1.06 to 6.68 D). The sherical equivalent refraction after suturing averaged -0.15 +/- 1.17 D (range, +3.75 to -2.50 D). Uncorrected visual acuity after suturing was 20/40 or better in 38 eyes (72%) and 20/50 to 20/100 in 15 eyes (28%). The number of eyes with a spherical equivalent refraction of +/- 0.50 D with 0.50 D or less refractive astigmatism was 15 (26% of eyes). There were 34 eyes (66%) with +/- 1.00 D with 1.00 D or less of refractive astigmatism, and 42 eyes (78%) with +/- 2.00 D with 2.00 D or less refractive astigmatism. Most of the spread was on the myopic side, as intended. There were no significant intraoperative or postoperative complications. Fifteen eyes gained two or more lines of best spectacle-corrected visual acuity and no eyes lost one line. CONCLUSION: Double intrastromal purse-string suturing produces steepening of the central cornea and reduces hyperopia after radial keratotomy.

Adult↗
PubMedDate not supplied

Bacterial keratitis following laser in situ keratomileusis for hyperopia.

A 42-year-old Bahraini man had uneventful laser in situ keratomileusis for hyperopia (OD: +3.00 +0.75 x 155 degrees; OS: +2.00 +0.50 x 155 degrees). Three weeks later, he presented with localized keratitis in his right eye, with localized keratitis at the flap margin with stromal edema. Uncorrected visual acuity was 20/80 OD with no improvement with pinhole, and was 20/20 OS. Corneal smear culture showed a positive growth of Staphylococcus aureus. The patient was immediately treated with subconjunctival gentamicin and intensive topical ofloxacin 0.3% with systemic cephalosporin. The patient recovered from keratitis within 2 weeks and his uncorrected visual acuity OD improved to 20/20. Keratitis following LASIK should be treated promptly so that it does not lead to permanent reduction in visual acuity.

Adult↗
PubMedDate not supplied

Histology of rabbit corneas after 10-diopter photorefractive keratectomy for hyperopia.

PURPOSE: To measure histological changes in the optical and transition zones of rabbit corneas treated with excimer laser photorefractive keratectomy (PRK) to correct hyperopia and to estimate the optical effect of these changes on the induced power profile. METHODS: Corrections of +10.00 D were ablated by means of a Questek 2620 excimer laser and rotational masks on 8 rabbit eyes. On frozen sections of 4 stained corneas and historesine sections of 4 other corneas, stromal, new stromal, epithelial, and total corneal thickness were measured on four significant locations. The optical effect of each parameter on the axial power profile was estimated in a computer simulation. RESULTS: Mean stromal regrowth was 50% of the ablated tissue. Deposition was lenticular and could account for -5.00 D of regression. Stromal thickening without regrowth occurred in the optical zone and over the shoulder, causing augmentation instead of regression. The epithelium thickened 20% in the mid-transition zone and was thinner over the shoulder, accounting for 1.00 D of regression and an increase in asphericity in the optical zone. CONCLUSION: In these hyperopic rabbit PRK corneas, stromal regrowth and epithelial hyperplasia were lenticular and contributed to regression of the optical effect. Stromal swelling around interrupted collagen lamellae seemed to occur, augmenting the optical effect. The epithelium filters high spatial frequency stromal irregularities.

Animals↗
PubMedDate not supplied

Intraocular lens implantation and laser in situ keratomileusis (bioptics) to correct high myopia and hyperopia with astigmatism.

PURPOSE: To analyze the refractive outcome of moderate to high myopic and hyperopic patients with astigmatism who underwent programmed refractive surgery; first lens phacoemulsification with intraocular lens implantation and 3 months later, laser in situ keratomileusis (LASIK). METHODS: Four men and eight women (22 eyes) with a mean age 47.3 years (range, 38 to 75 yr), and an average spherical equivalent refraction of -11.76 D and +5.22 D and (range, -17.50 to +8.50 D) underwent two refractive procedures. First, phacoemulsification of the lens with a self-sealing incision through clear cornea on the steepest topographic axis and implant of a monofocal intraocular lens in the bag was performed by two experienced surgeons. Second, LASIK was performed with the Nidek EC-5000 excimer laser and the Moria LSK-One microkeratome, by one surgeon. Eyes were divided into two different groups. In the first group, the IOL implanted was calculated to leave the eye slightly myopic, with final correction to be achieved with LASIK. In the second group, the IOL implanted was calculated to achieve emmetropia, correcting any residual refractive error with the laser. RESULTS: After surgery, mean spherical equivalent refraction was +0.26 D (range, -0.375 to +1.50 D). Predictability of refractive outcome: 0 to -1.00 D, 63.63%; +0.25 to +1.00 D, 31.80%; +1.25 to +2.00 D, 4.54%. Mean residual refractive astigmatism was 0.30 D (range, 0 to 1.50 D). Uncorrected visual acuity of 20/20 or better was achieved in 18.3% of eyes; 20/40 or better in 81.8%. No eyes lost two or more Snellen lines of visual acuity and no adverse effects were observed. CONCLUSIONS: Bioptics (phacoemulsification with IOL implantation followed 3 months later by LASIK with the Nidek EC-5000 excimer laser) for correction of moderate to high myopia and hyperopia, with astigmatism, enabled us to treat the total refractive error and adjust final outcomes.

Adult↗
PubMedDate not supplied

Results of photorefractive keratectomy for hyperopia using the VISX star excimer laser system.

PURPOSE: To evaluate safety, efficacy, and predictability of photorefractive keratectomy (PRK) for hyperopic astigmatism of +1.75 to 00 D manifest refractive sphere and up to -2.50 D manifest refractive astigmatism using the VISX Star excimer laser system, version 2.5 software. METHODS: Treatment was performed on 32 eyes of 21 patients. Eighteen of 21 patients were 45 years of age or older. Manifest and cycloplegic refraction together with Pelli-Robson contrast sensitivity assessment was performed prior to surgery and 1, 3, 6, 12, and 24 months after treatment. RESULTS: Twenty-seven of 32 surgical procedures were reviewed 1 year after treatment (84%). Corneal epithelial healing was complete between day 4 and 10. Twelve months after treatment, 25 of 27 eyes (93%) achieved 20/40 or better uncorrected visual acuity and 19 eyes (70%) achieved 20/20. No patient lost two or more lines of Snellen visual acuity assessed 6 months and later after treatment. The mean spherical equivalent refraction was reduced from +2.90 at baseline to +0.10 D at 1 year and +0.40 D at 2 years; 65% of eyes had a refraction within +/- 0.50 D. Four patients had further treatment by laser in situ keratomileusis for undercorrection in three eyes and overcorrection in one eye. Pelli-Robson contrast acuity was significantly reduced 12 months after treatment from a mean 1.72 before to 1.66 after PRK (P = .02, t-test). CONCLUSIONS: PRK for hyperopia using the VISX Star excimer laser system was effective in the treatment of hyperopic astigmatism. Although no patient lost two or more lines of high contrast best spectacle-corrected Snellen visual acuity 1 year after treatment, there was a significant decrease in Pelli-Robson contrast acuity.

Adult↗
PubMedDate not supplied

Treatment of hyperopia: a new ablation profile to reduce corneal eccentricity.

PURPOSE: Hyperopic treatment normally increases corneal eccentricity (the measure of corneal asphericity). Information derived from treating corneal white scars occurring after hyperopic ablations suggests that reducing corneal eccentricity through central corneal flattening followed by smoothing eliminates scarring and prevents its recurrence. METHODS: We treated two groups of patients; Group 1 included 18 eyes of 18 patients with whitish corneal scar due either to photorefractive keratectomy (PRK) (n = 16, 88.9%) or laser in situ keratomileusis (LASIK) (n = 2, 11.1%). Mean preoperative spherical equivalent refraction was +1.20 +/- 2.30 D, and mean corneal eccentricity was +1.2 +/- 0.8. We performed phototherapeutic keratectomy (PTK) to achieve central corneal flattening and decrease corneal eccentricity, coupled with smoothing, using the Nidek EC-5000 excimer laser. Group 2 included 27 eyes of 27 consecutive patients with mean preoperative spherical equivalent refraction of +2.40 +/- 1.30 D; these patients had laser epithelial keratomileusus (LASEK) with the Nidek EC-5000 excimer laser. A new Nidek aspheric ablation profile with a wider optical zone (6.7 mm) and transition zone (9.5 to 10.00 mm) was applied. RESULTS: In Group 1 eyes, the apical scar disappeared in all eyes. Postoperative spherical equivalent refraction was +1.8 +/- 1.02 D and mean postoperative eccentricity was +0.9. In Group 2 eyes after 9 months of follow-up, mean postoperative spherical equivalent refraction was -0.30 +/- 0.30 D, with no loss of lines of BSCVA. Low corneal eccentricity values were maintained, which created a gradual change in the rate of curvature. CONCLUSIONS: The new Nidek profile for hyperopia treatment allowed successful refractive correction and maintained low eccentricity values that approached those of a normal cornea.

Cornea↗
PubMedDate not supplied

Changes in intraocular pressure after laser in situ keratomileusis for myopia, hyperopia, and astigmatism.

PURPOSE: Reports have shown that photorefractive keratectomy changes intraocular pressure (IOP) in myopic eyes by changing the thickness and curvature of the cornea. Changes in intraocular pressure after laser in situ keratomileusis (LASIK) for hyperopia led the authors to evaluate IOP after LASIK for various refractive errors. METHODS: The measurement of intraocular pressure with a Goldman applanometer in the central cornea was evaluated before and 3 months after LASIK in 100 eyes of 55 patients with various refractive errors. Corneal thickness (pachymetry) and corneal topography were evaluated. RESULTS: After LASIK, a significant decrease of intraocular pressure was observed in most eyes: mean 11.9 +/- 3.2 mmHg before and 9.8 +/- 2.6 mmHg at 3 months after surgery (P < .001). Mean decrease in IOP was 2.75 +/- 3.3 mmHg (P < .0001) for myopic eyes, 2.28 +/- 2.43 mmHg (P < .001) for hyperopic eyes, and 1.47 +/- 2.5 mmHg (P < .0012) for astigmatic eyes. IOP reduction was not significantly correlated to the amount of ablation (r = 0.05) or to corneal thickness. CONCLUSION: Intraocular pressure decreased in myopic, hyperopic, and astigmatic eyes after LASIK. The reduction was not correlated to the amount of tissue removed or to flattening or steepening of the central cornea.

Adolescent↗
PubMedDate not supplied

Total and corneal optical aberrations induced by laser in situ keratomileusis for hyperopia.

PURPOSE: To evaluate changes induced by standard laser in situ keratomileusis (LASIK) for hyperopia on total and corneal optical quality. METHODS: Total and corneal aberrations were measured before and after standard hyperopic LASIK in 13 eyes (preoperative spherical equivalent refractive error +3.17 +/- 1.10 D). The Chiron Technolas 217C laser with PlanoScan was used. Total aberrations (measured using laser ray tracing) and corneal aberrations (estimated from a videokeratoscope) were described using Zernike terms. Root-mean-square wavefront error for both total and corneal aberrations, and through-focus Strehl ratio for the point spread function of the whole eye were used to assess optical changes induced by surgery. RESULTS: Third and higher order aberrations increased significantly after hyperopic LASIK (by a factor of 2.20 for total and 1.78 for corneal aberrations, for a 6.5-mm pupil). Spherical aberration changed to negative values (corneal average decreased by -0.85 +/- 0.48 microm and total average by -0.70 +/- 0.30 microm). Best Strehl ratio for the whole eye decreased by a factor of 1.84. Hyperopic LASIK induced larger changes than myopic LASIK, compared to an equivalent group of myopic eyes from a previous study. Induced corneal spherical aberration was six times larger after hyperopic LASIK, for a similar range of correction, and of opposite sign. As with myopic LASIK, changes in internal spherical aberration are of opposite sign to those induced on the corneal anterior surface. CONCLUSIONS: Hyperopic LASIK induced significant amounts of aberrations. The largest increase occurred in spherical aberration, which showed a shift (toward negative values) of opposite sign; increase was greater than for myopic LASIK.

Adult↗
PubMed1999

Congenital stapes ankylosis, broad thumbs, and hyperopia: report of a family and refinement of a syndrome.

We report on a family with conductive hearing loss due to congenital stapes ankylosis, and with hyperopia, broad thumbs, and broad first toes. Neither of the studied relatives had symphalangism, possibly distinguishing this syndrome as an entity separate from the facio-audio-symphalangism and proximal symphalangism syndromes. An alternative possibility is that this family falls within the spectrum of the facioaudio-symphalangism and proximal symphalangism syndromes. Visualization of the ossicular chain, and ophthalmologic and radiologic studies are important in the evaluation of families with congenital conductive hearing loss. A characteristic physiognomy in our patients is present; this autosomal dominant syndrome was first described by Teunissen and Cremers [1990: Laryngoscope 100:380-384].

Adult↗
PubMed2000

SHORT syndrome: a case with high hyperopia and astigmatism.

We describe a case of the SHORT syndrome and compare it with previously published cases. This six-year-old girl shows nearly all the typical manifestations reported in patients with the SHORT syndrome, including lipoatrophy, minor facial anomalies, Rieger anomaly, and short stature. However, she also suffers from high hyperopia and astigmatism associated with poor visual acuity.

Abnormalities, Multiple↗
PubMed2000

Excimer laser treatment of spherical hyperopia: PRK or LASIK?

PURPOSE: To compare the efficacy and safety of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in the treatment of spherical hyperopia with use of the VISX STAR S2 excimer laser. METHODS: A review of 15 consecutive patients (22 eyes) receiving PRK and 22 consecutive patients (26 eyes) receiving LASIK (median follow-up, 12 months). RESULTS: Mean age was 52 +/- 7 years for patients receiving PRK and 55 +/- 9 years for patients receiving LASIK. Mean preoperative spherical equivalent was +2.25 +/- 1.16 D for PRK patients and +1.81 +/- 0.92 D for LASIK patients. Mean deviation from intended correction was -0.82 +/- 0.89 D after PRK and +0.19 +/- 0.47 D after LASIK at 1 month (P < .01); +0.16 D +/- 0.37 D after PRK and +0.29 +/- 0.51 D after LASIK at 6 months (P = .906); +0.20 +/- 0.35 D after PRK and +0.37 +/- 0.44 D after LASIK at 1 year (P = .301). At 1 year, 83.3% of PRK eyes and 61.5% of hyperopic LASIK eyes were within +/- 0.50 D of intended correction (P = 1.0). At 1 year, all eyes in both groups had acuity of 20/40 or better uncorrected, and 47.1% of PRK eyes and 54.5% of LASIK eyes had acuity of 20/20 or better uncorrected (P = 1.0). At last follow-up (minimum, 6 months), 2 eyes in each group had lost 2 lines of best spectacle-correct visual acuity, but none had lost more than 2 lines. All PRK patients experienced significant postoperative pain that required systemic medication. LASIK patients had only minor, transient discomfort. CONCLUSION: LASIK and PRK are of comparable efficacy and safety. However, PRK was associated with significant post-operative pain, an initial and temporary myopic overshoot peaking at 1 month, and stability not occurring before 6 months. LASIK was less painful and was associated with more rapid stability (at 1 month) and a trend toward better uncorrected visual acuity, although not statistically significant.

Female↗
PubMed2001

Surgical correction of hyperopia: clear lens extraction and laser correction.

Modern ophthalmology offers a series of surgical procedures to correct a wide range of hyperopia and hyperopic astigmatism. Varies excimer lasers and thermal lasers have been proven safe and effective. Phakic implants and clear lens extraction offers alternatives for moderate to high hyperopic patients. Indications, techniques, and clinical study results were reviewed and summarized.

Cornea↗