Wydanie 2/2006

Własne obserwacje korekcji nadwzroczności

Own Experience in Hyperopia Correction

Elżbieta Archacka1, Małgorzata Gadomska1, Iwona Liberek1,2, Justyna Izdebska1,3, Jerzy Szaflik1,3

1 Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Po. kierownika: dr n. med. Iwona Liberek
3 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademii Medycznej w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik

Summary: Due to their structure, hyperopic eyes have always represented a big problem for refractive surgeons. The gradual refinement of the diagnostic and surgical equipment coupled with introduction of new operation techniques translates into increasingly better outcomes of hyperopia procedures. Auschütz was the first to use excimer laser to correct hyperopia in Germany in 1990. The value of hyperopia and hyperopic astigmatism qualified for the procedure bears a huge impact on its outcome. Initially, errors of up to +8.0 D and astigmatism of up to –6.0 D were qualified. At present, the best results are achieved at Eye Microsurgery Centre LASER in myopia of up to +6.0 D and astigmatism of up to +6.0 D.
Further new operating procedures were gradually put into use. They were PRK, LASIK,LASEK and, most recently, Epi-LASIK. The highest number of complications was observed in PRK: around 35-40% of eyes developed peripheral haze.
A number of patients were diagnosed for loss of visual acuity ranging from 1 to 2 Snellen lines, deteriorated contrast sensitivity and dispersion of light, particularly acute at night. Also, error remissions ranged from 30% to 40% after 6 months with a tendency to persist over the following months and years. LASIK has also failed to meet the expectations and has been virtually discontinued in hyperopia correction by a number of eye care centres. Eye Microsurgery Centre Laser has achieved the best results in hyperopia treatment with the LASEK method, which we have been applying for 4 years now. In addition, we have been combining it with post-op Mitomycin C, which reduces keratocyte activation thus bearing a notable effect on the outcome of the procedure. Selection of optical zone is also significant for the outcome – the best zone is in the range from 6.5 to 7 mm. Compared with Slit Beam laser, Flying Spot laser offer much better results in hyperopia treatment.
We have applied the latest method Epi-LASIK to 15 eyes with hyperopia and hyperopic astigmatism below +3 D. Our initial evaluation indicates that this method is comparable to LASEK and LASEK with Mitomycin C.

Keywords: Hyperopia Correction, PRK, LASIK, LASEK, Epi-LASIK