Laser-Assisted in Situ Keratomileusis with Optimized, Fast-Repetition, and Cyclotorsion Control Excimer Laser to Treat Hyperopic Astigmatism with High Cylinder

Eur J Ophthalmol. 2017 Nov 8;27(6):686-693. doi: 10.5301/ejo.5001051.


Purpose: To evaluate the visual outcomes after femtosecond laser-assisted laser in situ keratomileusis (LASIK) surgery to correct primary compound hyperopic astigmatism with high cylinder using a fast repetition rate excimer laser platform with optimized aspheric profiles and cyclotorsion control.

Methods: Eyes with primary simple or compound hyperopic astigmatism and a cylinder power ≥3.00 D had uneventful femtosecond laser-assisted LASIK with a fast repetition rate excimer laser ablation, aspheric profiles, and cyclotorsion control. Visual, refractive, and aberrometric results were evaluated at the 3- and 6-month follow-up. The astigmatic outcome was evaluated using the Alpins method and ASSORT software.

Results: This study enrolled 80 eyes at 3 months and 50 eyes at 6 months. The significant reduction in refractive sphere and cylinder 3 and 6 months postoperatively (p<0.01) was associated with an improved uncorrected distance visual acuity (p<0.01). A total of 23.75% required retreatment 3 months after surgery. Efficacy and safety indices at 6 months were 0.90 and 1.00, respectively. At 6 months, 80% of eyes had an SE within ±0.50 D and 96% within ±1.00 D. No significant differences were detected between the third and the sixth postoperative months in refractive parameters. A significant increase in the spherical aberration was detected, but not in coma. The correction index was 0.94 at 3 months.

Conclusions: Laser in situ keratomileusis for primary compound hyperopic astigmatism with high cylinder (>3.00 D) using the latest excimer platforms with cyclotorsion control, fast repetition rate, and optimized aspheric profiles is safe, moderately effective, and predictable.

Keywords: Fast repetition rate excimer laser; High cylinder; Hyperopic astigmatism; Laser in situ keratomileusis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Cornea / pathology
  • Cornea / surgery
  • Female
  • Humans
  • Intraocular Pressure / physiology
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer / therapeutic use*
  • Male
  • Middle Aged
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Software
  • Surgical Flaps
  • Treatment Outcome
  • Visual Acuity / physiology