Lamellar keratoplasty for hyperopia

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Abstract

Lamellar keratoplasty for hyperopia (automated lamellar keratoplasty for hyperopia) can correct hyperopia by weakening the cornea with a deep lamellar resection. The safety and efficacy of the procedure is uncertain.Twenty-four eyes of 17 patients underwent hyperopic lamellar keratoplasty using the automated corneal shaper (Chiron Corp, Irvine, Calif) by one surgeon using a flap technique. The mean attempted correction was +3.90 +/- 0.90 D (range, +2.00 to +6.00). The eyes were followed for 1 month (23 eyes) to 6 months (17 eyes).Six months after hyperopic lamellar keratoplasty, the mean difference between attempted and achieved correction was an undercorrection of +1.40 +/- 0.80 diopters (D) with 7 of 17 eyes within 1.00 D of the attempted correction. No eyes were overcorrected, and 15 eyes were undercorrected. In eyes with a refractive goal of emmetropia, uncorrected visual acuity was 20/40 or better in 13 of 15 eyes and 20/20 or better in 8 of 15 eyes. No eye lost two or more lines of spectacle-corrected visual acuity at 3 or 6 months postoperatively. Between 1 and 6 months, there was a mean hyperopic shift of 0.20 D. There was clinically significant epithelial ingrowth into the interface in two eyes.Hyperopic lamellar keratoplasty is an effective method of reducing hyperopia and induces little irregular astigmatism. The nomogram we used produces a consistent undercorrection. Refraction appears to stabilize at 1 month, but longer follow up is necessary to assess stability.

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