Changes of Functional Optical Zone After LASIK for Hyperopia and Hyperopic Astigmatism

PURPOSE: To evaluate which factors may influence the size of the postoperative functional optical zone after hyperopic LASIK. METHODS: Thirty-three eyes with a mean spherical equivalent of +3.55 ± 1.28 diopters (D) underwent LASIK with a Technolas 217 C-LASIK laser (Bausch & Lomb Surgical, Munich, Germany). After 1 week and 1, 4, and 12 months, the authors examined refraction, corneal refractive power by means of computerized videokeratography (Technomed C-Scan; Baesweiler, Germany), and uncorrected/corrected distance visual acuity (UDVA/CDVA). According to the degree of hyperopia, they were divided into low hyperopia (spherical equivalent ≤ 3.00 D) and high hyperopia (spherical equivalent > 3.00 D) groups. RESULTS: One year postoperatively, 82% of all eyes had a UDVA of 0.5 or better; in 88%, the spherical equivalent did not deviate more than 1.00 D from the attempted value. Three eyes were slightly undercorrected. After an initial overcorrection (−0.27 D) with subsequent regression, the refraction remained stable at +0.17 D from the fourth postoperative month (low hyperopia group: +0.14 D; high hyperopia group: +0.19 D after 1 year). After 1 year, the functional optical zone diminished by 32%; the reduction was more pronounced in eyes with higher hyperopia: −1.85 ± 1.09 mm (range: +0.5 to −3.4 mm) in the low hyperopia group ( P < .0001) and −2.25 ± 1.24 mm (range: +1 to −3.9 mm) in the high hyperopia group ( P < .0001). Preoperative spherical equivalent and preoperative corneal refractive power affected the postoperative size of the functional optical zone additively. CONCLUSIONS: An expected small functional optical zone in high hyperopia may not be regarded as a compelling exclusion criterion, but can induce possible side effects such as glare and halos. [ J Refract Surg. 2018;34(7):476–481.]