Journal d'ophtalmologie clinique et expérimentale
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A Comparative Assessment of Ocular Aberrations Before and After LASEK Surgery in Hyperopic and Hyperopic Astigmatism Patients

Abdolla Farzaneh, Farid Karimian, Mohammad Aghazadeh Amiri, Seyed Mehdi Tabatabaei and Maryam Heydarpour Meymeh

Background & aim: The studies have shown that by an increase in the aberrations and visual performance might be affected by the ocular aberrations after the corneal refractive surgery. This study was to investigate the effects of LASEK surgery on the ocular aberrations in hyperopic and hyperopic astigmatism patients.
Methods: In this analytical & descriptive study 35 patients (11 men, 24 women) having LASEK surgery using the Technolas 217 z were divided into 3 groups of preoperative hyperopia as mild (+0.50-+1.75), moderate (+2.00-+3.00), and high (+3.25-+5.00). The preoperative and 6 month postoperative UCVA, BSCVA, subjective refraction, HOAs values of coma, trefoil, spherical aberration, 2nd astigmatism, quadrafoil, pentafoil, total higher-order aberrations were measured with 6mm pupils using the zywave II aberrometer. The mean spherical equivalent, hyperopia, cylinder, HOAs, and total aberrations were compared to LASEK surgery on optical qualify of the eye.
Results: Total aberrations significantly decreased after hyperopic LASEK in all of groups but HOAs increased after LASEK in three groups for a 6 mm pupil, especially 4th order aberration (Z40) and 2nd astigmatism (Z42). The largest increase occurred in spherical aberration and 2nd astigmatism. The Spherical aberration (Z40) was greater for high hyperopia group with larger hyperopia and moderate astigmatism. The spherical aberration showed a shift (toward positive values) of opposite sign. The 2nd astigmatism was greater for mild and moderate hyperopia group. Postoperative UCVA was same in mild and moderate hyperopia group and better than high hyperopia group.
Conclusions: Wave-front LASEK surgery using Technolas 217 Z was an effective, safe, and predictable procedure for treating hyperopic and hyperopic astigmatism patients with hyperopia up to +3.25 and astigmatism less than -3.00, but in hyperopic patients with hyperopia more than +3.25 due to a significant increase in high-order aberrations (HOAs) and further reduction of visual acuity didn't seem appropriate approach.