Total and corneal optical aberrations induced by laser in situ keratomileusis for hyperopia.

Purpose: To evaluate changes induced by standard laser in situ keratomileusis (LASIK) for hyperopia on total and corneal optical quality.

Methods: Total and corneal aberrations were measured before and after standard hyperopic LASIK in 13 eyes (preoperative spherical equivalent refractive error +3.17 +/- 1.10 D). The Chiron Technolas 217C laser with PlanoScan was used. Total aberrations (measured using laser ray tracing) and corneal aberrations (estimated from a videokeratoscope) were described using Zernike terms. Root-mean-square wavefront error for both total and corneal aberrations, and through-focus Strehl ratio for the point spread function of the whole eye were used to assess optical changes induced by surgery.

Results: Third and higher order aberrations increased significantly after hyperopic LASIK (by a factor of 2.20 for total and 1.78 for corneal aberrations, for a 6.5-mm pupil). Spherical aberration changed to negative values (corneal average decreased by -0.85 +/- 0.48 microm and total average by -0.70 +/- 0.30 microm). Best Strehl ratio for the whole eye decreased by a factor of 1.84. Hyperopic LASIK induced larger changes than myopic LASIK, compared to an equivalent group of myopic eyes from a previous study. Induced corneal spherical aberration was six times larger after hyperopic LASIK, for a similar range of correction, and of opposite sign. As with myopic LASIK, changes in internal spherical aberration are of opposite sign to those induced on the corneal anterior surface.

Conclusions: Hyperopic LASIK induced significant amounts of aberrations. The largest increase occurred in spherical aberration, which showed a shift (toward negative values) of opposite sign; increase was greater than for myopic LASIK.