Short-Term Clinical Results of Hyperopic LASEK in Korean Patients

Se Hyun Choi; Seong Joon Kim; Mee Kum Kim; Won Ryang Wee

doi:10.3341/jkos.2015.56.10.1257

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Choi, Kim, Kim, and Wee: Short-Term Clinical Results of Hyperopic LASEK in Korean Patients

Original Article

J Korean Ophthalmol Soc 2015;56(10):1527-1533.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.10.1257

Short-Term Clinical Results of Hyperopic LASEK in Korean Patients

Se Hyun Choi, M.D¹, Seong Joon Kim, M.D¹, Mee Kum Kim, M.D, PhD^1,^2,, Won Ryang Wee, M.D, PhD^1,²

¹Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

²Seoul Artificial Eye Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea

Address reprint requests to Mee Kum Kim, MD, PhD Department of Ophthalmology, Seoul National University Hospital, #101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: 82-2-2072-2665, Fax: 82-2-741-3187 E-mail: kmk9@snu.ac.kr

Received 28 November 20142 June 2015 Accepted 31 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate short-term clinical outcomes following hyperopic laser-assisted subepithelial keratomileusis (LASEK) in Korean patients.

Methods

This retrospective study included 18 eyes of 10 patients who underwent hyperopic LASEK between May 2005 and March 2013 in Seoul National University Hospital. Visual acuity and spherical equivalent were evaluated preoperatively and at 1 and 3 months postoperatively. High order aberrations and contrast sensitivity were measured before and 3 months after the operation. Alternative prism cover test (APCT) was performed both preoperatively with correction and postoperatively without correction.

Results

The mean age of patients was 32 ± 11 years and the mean spherical equivalent refractive error was -2.95 ± 1.24 diop-ters (D). Uncorrected visual acuities were log MAR +0.17 ± 0.15 and log MAR +0.14 ± 0.15 at postoperative 1 month and 3 months, respectively and showed no significant difference in best corrected visual acuity (+0.25 ± 0.30). Spherical equivalent was -0.22 ± 1.22 D at 1 month and 0.38 ± 0.91 D at 3 months postoperatively. In 6 patients who had esotropia before the oper-ation, APCT was 7.83 ± 3.60 prism diopters (PD) esotropia at distance with correction preoperatively and 4.67 ± 5.65 PD at dis-tance without correction postoperatively. Three patients (16.7%) showed delayed wound healing with 1 (5.56 %) having persis-tent corneal opacity without significant visual loss.

Conclusions

The effect of LASEK may be comparable for correcting hyperopia and esotropia when compared with the effect of previous reports; however, delayed wound healing may be a concern.

Keywords: Accommodative esotropia, Hyperopia, LASEK, Strabismus, VISX S4

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Figure 1.

Visual acuity change preoperatively, 1 month and 3 months postoperatively. The visual acuity was converted to decimal form after calculation of mean and standard deviation with log MAR visual acuity (no statistical difference between preoperative and postoperative 1 and 3 months).

Figure 2.

SE change preoperatively, 1 month and 3 months postoperatively. SE = spherical equivalent. ^* p < 0.05, paired samples t-test.

Figure 3.

Predictability. The percentage of eyes within ±0.5 D and ±1.0 D of intended correction. SE = spherical equivalent.

Figure 4.

Comparison of pre- and postoperative 3 months high order aberration values. HOA = high order aberration. ^* p < 0.05, paired samples t-test.

Figure 5.

Mean contrast sensitivity (in logarithmic scale) at pre- and postoperative 3 months.

Table 1.

Patients preoperative and postoperative demographics

Case	Gender/age (years)	Preop BCVA (OD/OS, log MAR)	Preop SE (OD/OS, D)	Preop deviation (PD)	Laterality	Operation	Pupil diameter (OD/OS, mm)	Postop UCVA (OD/OS, log MAR)	Postop SE (OD/OS, D)	Postop deviation (PD)	Follow-up duration (months)	Postop complications
1	F/22	0.046/0.097	+ 1.25/+3.13	20XT	OU	LASEK	5.1/5.1	0.155/0.097	+0.25/ + 1.63	20XT	10
2	M/32	-0.079/0	+2.00/+1.94	8ET 14RH	OU	LASEK	4.9/4.8	-0.079/0.046	- 0.50/-0.75	9ET 13RH	12
3	F/38	0.155	+ 1.00	10ET	OD	LASEK	5.1	0.097	+0.125	14ET	7
4	F/21	-0.079	+2.88	3ET	OD	LASEK	4.0	-0.079	0.00	3ET	8	Delayed healing (OU)
5	F/58	0.097/0.046	+ 1.75/+2.00	Ortho	OU	LASEK	4.0/3.9	0/0.046	+0.50/+0.50	Ortho	12
6	F/28	0/0	+2.50/+2.63	Ortho	OU	LASEK	4.7/4.1	0/0.155	-0.75/-1.13	Ortho	1
7	M/22	0/0	+4.00/+4.00	10ET 4LH	OU	LASEK	3.4/3.7	0.097/0.222	+0.63/+0.25	2ET 4LH	4
8	F/24	-0.176/0	+2.25/+3.25	4ET	OU	Custom LASEK	5.3/5.4	0.046/0.046	+0.88/0	Ortho	6
9	F/36	0.222/0.046	+5.00/+5.00	Ortho	OU	Custom LASEK	3.6/3.7	0.155/0.155	+3.25/+2.50	Ortho	12
10	F/36	0.046/0.523	+4.00/+4.50	12ET	OU	LASEK	3.3/3.8	0.046/0.523	0.00/+2.75	Ortho	15	Delayed healing (OU), persistent opacity (OS)

Preop = preoperative; BCVA = best corrected visual acuity; SE = spherical equivalent; deviation = angle of deviation; PD = prism diopter; Postop = postoperative; UCVA = uncorrected visual acuity; F = female; M = male; XT = exotropia; OU = oculus uterque (both eyes); LASEK = laser assisted subepithelial keratectomy; ET = esotropia; RH = right hypertropia; OD = oculus dexter (right eye); OS = oculus sinister (left eye); Ortho = orthotropia; LH = left hypertropia.

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