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.