LAUSR

PURPOSE To evaluate the long term visual and refractive outcomes of hyperopic excimer ablation using alcohol-assisted PRK and femtosecond laser-assisted LASIK. SETTING American University of Beirut Medical Center, Beirut, Lebanon. DESIGN Retrospective, matched comparative study. METHODS 83 eyes that underwent alcohol-assisted PRK and 83 matched eyes that underwent femtosecond laser-assisted LASIK for the correction of hyperopia were compared. All patients were followed up for at least 3 years after surgery. The refractive and visual outcomes of each group were compared at different postoperative time points. The main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction, and visual acuity. RESULTS Preoperative manifest refraction spherical equivalent was 2.44±1.18D and 2.20±0.87D (p = 0.133) in PRK and F-LASIK groups, respectively. Preoperative manifest cylinder was -0.77±0.89D and -0.61±0.59D (p = 0.175) for PRK and LASIK groups, respectively. 3 years postoperatively, SEDT was 0.28 ± 0.66 D and 0.40±0.56D for PRK and LASIK groups, respectively (p = 0.222), while manifest cylinder was -0.55±0.49D and -0.30±0.34D for PRK and LASIK, respectively (p < 0.001). Mean difference vector was 0.59±0.46 for PRK and 0.38±0.32 for LASIK (p < 0.001). 13.3% of PRK eyes and 0% of LASIK eyes had >1D of manifest cylinder (p = 0.003). CONCLUSIONS Both alcohol-assisted PRK and femtosecond laser-assisted LASIK are safe and effective for the treatment of hyperopia. PRK induces slightly more postoperative astigmatism than LASIK. Larger optical zones, and recently introduced ablation profiles that lead to a smoother ablation surface might improve the clinical results of hyperopic PRK.