Hyperopic laser keratorefractive surgery: Do steep corneas have worse outcomes?

Purpose To report the visual and refractive outcomes of hyperopic patients undergoing laser keratorefractive surgery in preoperatively steep corneas versus a matched control group. Methods Retrospective cohort study. All patients underwent photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK) at Care-Vision Laser Centers, Tel-Aviv, Israel, between 1/2000 and 11/2016. Patients were divided into two groups: steep corneas (mean keratometry >= 44.00 D) and control group (mean keratometry < 44.00 D). The two study groups were matched by age, gender, sphere and cylinder. Only the right eye of each patient was included. Outcomes included postoperative uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (CDVA), safety and efficacy indexes, refractive outcomes and retreatment rates. Results Five hundred and two patients were included. Both groups were similar in demographic data, visual acuity and refraction. Postoperatively, the steep corneas group had a significantly higher mean keratometry as compared to the control group (46.52 +/- 1.43 D vs 44.58 +/- 1.68 D, p < 0.001), K-min (46.04 +/- 1.50 D vs 44.12 +/- 1.76 D, p < 0.001) and K-max (46.99 +/- 1.51 D vs 45.03 +/- 1.77 D, p < 0.001). Both groups had similar postoperative UDVA and CDVA and achieved a similar final sphere (0.64 +/- 0.19 vs 0.54 +/- 1.19, p = 0.44) and cylinder (- 0.89 +/- 0.59 vs - 0.86 +/- 0.72, p = 0.67). Both groups had a similar efficacy index (0.92 +/- 0.22 vs 0.90 +/- 0.25, p = 0.33) and similar retreatment rates (4.2% vs 3.5%, p = 0.74). None of the patients in either group underwent more than one retreatment throughout the follow-up period. Conclusions Hyperopic patients with steep corneas undergoing laser keratorefractive surgery can achieve adequate visual and refractive outcomes, similar to control group.