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NR. 2/2006
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Własne obserwacje
korekcji nadwzroczności
Own Experience in Hyperopia Correction
Elżbieta Archacka1,
Małgorzata Gadomska1, Iwona Liberek1,2,
Justyna Izdebska1,3, Jerzy Szaflik1,3
1 Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Klinika Okulistyki Centrum Medycznego Kształcenia
Podyplomowego w Warszawie
Po. kierownika: dr n. med. Iwona Liberek
3 Katedra i Klinika Okulistyki II Wydziału
Lekarskiego Akademii Medycznej w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik |
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| Summary: |
Due to their structure,
hyperopic eyes have always represented a big problem for
refractive surgeons. The gradual refinement of the
diagnostic and surgical equipment coupled with
introduction of new operation techniques translates into
increasingly better outcomes of hyperopia procedures.
Auschütz was the first to use excimer laser to correct
hyperopia in Germany in 1990. The value of hyperopia and
hyperopic astigmatism qualified for the procedure bears
a huge impact on its outcome. Initially, errors of up to
+8.0 D and astigmatism of up to –6.0 D were qualified.
At present, the best results are achieved at Eye
Microsurgery Centre LASER in myopia of up to +6.0 D and
astigmatism of up to +6.0 D.
Further new operating procedures were gradually put into
use. They were PRK, LASIK,LASEK and, most recently,
Epi-LASIK. The highest number of complications was
observed in PRK: around 35-40% of eyes developed
peripheral haze.
A number of patients were diagnosed for loss of visual
acuity ranging from 1 to 2 Snellen lines, deteriorated
contrast sensitivity and dispersion of light,
particularly acute at night. Also, error remissions
ranged from 30% to 40% after 6 months with a tendency to
persist over the following months and years. LASIK has
also failed to meet the expectations and has been
virtually discontinued in hyperopia correction by a
number of eye care centres. Eye Microsurgery Centre
Laser has achieved the best results in hyperopia
treatment with the LASEK method, which we have been
applying for 4 years now. In addition, we have been
combining it with post-op Mitomycin C, which reduces
keratocyte activation thus bearing a notable effect on
the outcome of the procedure. Selection of optical zone
is also significant for the outcome – the best zone is
in the range from 6.5 to 7 mm. Compared with Slit Beam
laser, Flying Spot laser offer much better results in
hyperopia treatment.
We have applied the latest method Epi-LASIK to 15 eyes
with hyperopia and hyperopic astigmatism below +3 D. Our
initial evaluation indicates that this method is
comparable to LASEK and LASEK with Mitomycin C. |
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| Key words: |
Hyperopia Correction, PRK,
LASIK, LASEK, Epi-LASIK. |
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