Holmium:YAG laser thermokeratoplasty (LTK), a procedure using a solid-state infrared laser to treat hyperopia, was performed on 10 patients in phase I and 16 patients in phase II--in a total of 29 eyes at the Hunkeler Eye Clinic. Phase II was redesigned after phase I results showed undercorrection and regression. The follow-up period ranged from 1 to 24 months (mean 10.9 months). A total of 79% of phase II patients were within +/- 1.00 D of intended correction at the 6-month visit. Looking at both phases together, no patients had J2 or better near vision preoperatively, but 75% had J2 or better at the 6-month visit. A total of 43% of eyes in phase II lost 1 line and 7% lost two lines of best spectacle corrected visual acuity due to induction of irregular astigmatism. The surgical challenges are to insure appropriate centration of the procedure about the optical axis. Concerns about regression and stability will be defined as these patients are followed through their 2-year visits.