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Bulgarian Review of Ophthalmology

Causative factors for hyperopia regression in excimer keratorefractive surgery

M. Litev, L. Voynov, T. Mitov, D. Radilov, A. Kalaydjiev


Regression and hypocorrection are specific complications in refractive surgery that frequently lead to unexpected or perishable refractive results. They develop due to unforeseen alteration in corneal biomechanics and are hard to differentiate and presume. Their ethiology and pathogenesis are still vague and no statistical evidence on predisposing factors is present. Once more familiar, the regression might be controlled by patient selection, procedure planning or laser platform opting. This study offers a completely new approach to the measurement of regression and statistically sound results in terms of the possible reasons and biomarkers.


H-LASIK; wavefront; regression, viscoelasticity; multifactorial analysis

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Results in refractive surgery. Epstein, Dan. London : ESCRS Annual congress, 2014. Refractive surgery didactic course.

Arbelaez MC, Knorz MC. Laser in situ keratomileusis for hyeropia and hyperopic astigmatism. Journal of Refractive Surgery. 1999 Jul- Aug, 15(4):406-14.

Azar, Dimitri T., Koch, Douglas. LASIK (Laser in Situ Keratomileusis): Fundamentals, Surgical Techniques, and Complications (Refractive Surgery, 1). 2007.

Jaycock, Philip D. MRCOphth, David P.S. O'Brart, MD, FRCS, Madhavan S. Rajan, FRCOphth, John Marshall, PhD. 5-year followup of LASIK for hyperopia. Ophthalmology. Presented at: Association for Research in Vision and Ophthalmology Annual Meeting, April, 2004; Fort Lauderdale, Florida, 2005 Feb, 112(2):191-9.

Lindstrom RL, D R Hardten, D M Houtman, B Witte, N Preschel, Y R Chu, T W Samuelson, and E J Linebarger. Six-month results of hyperopic and astigmatic LASIK in eyes with primary and secondary hyperopia. Trans Am Ophthalmol Soc. 1999, 97: 241-260. PMCID: PMC1298263.

FDA. FDA Letter to Eye Care Professionals, FDA Recognition of ANSI Laser Systems for Corneal Reshaping. [Online] [Cited: August

, 2014.]

Dupps Jr.WJ., Wilson SE. Biomechanics and Wound Healing in the Cornea. Experimental Eye Research. Oct 2006, 83(4): 709-720.

Corneal biomechanics. Roberts, Cynthia. London : ESCRS Annual congress, 2014.

Excimer laser photorefractive keratectomy with tapered transition zone for high myopia. A preliminary report of six cases. Dausch D, Klein R, Schröder E, Dausch B. 19(5):590-4., Sep 1993, J Cataract Refract Surgery.

Azar Dimitri T., Camellin Massimo, Yee Richard W. LASEK, PRK, and Excimer Laser Stromal Surface Ablation. s.l. : CRC Press, 2004.p. 360.

Ivarsen, Anders, Walther Fledelius and Jesper Ø. Hjortdal. Three-Year Changes in Epithelial and Stromal Thickness after PRK or LASIK for High Myopia. Investigative Ophthalmology and Visual Science. May 2009, Vol. 50, 5 2061-2066.

Reinstein DZ, Archer TJ, Gobbe M, Silverman RH, Coleman DJ. Epithelial thickness after hyperopic LASIK: three-dimensional display with Artemis very high-frequency digital ultrasound. J Refract Surg. 2010 Aug;, 26(8): 555-64.

Moilanen JAO, J M Holopainen, M H Vesaluoma, T M T Tervo. Corneal recovery after lasik for high myopia: a 2-year prospective confocal microscopic study. British Journal of Ophthalmology. 2008, 92:1397-1402.

Erie, Jay C. MD, Cherie B. Nau, BS, Jay W. McLaren PhD, David O. Hodge MS, William M. Bourn􀉟 MD. Long-term keratocyte deficits in the corneal stroma after LASIK. Transactions of American Ophthalmology Society. Presented as a poster at: American Academy of Ophthalmology Annual Meeting November 15-18, 2003, 2005, 103:56-66; discussion 67-8.

Румянцева, О. А. Клинико-биологические аспекты регенерации роговицы после фоторефракционной кератэктомии. [Онлайн]2003 r. [Цитирано на: 1412 2013 r.]

Stromal wound healing explains refractive instability and haze development after photorefractive keratectomy: a 1-year confocal microscopic study. Moller-Pedersen T, CavanaghHD, Petroll WM, Jester JV. 107(7):1235-45., Jul 2000, Ophthalmology.

Laser in situ keratomileusis. Pallikaris IG, Papatzanaki ME, Stathi EZ, Frenschock O, Georgiadis A. 10(5):463-8., 1990, Lasers Surg Med. .

Excimer laser in situ keratomileusis under a corneal ap for myopia of 2 to 20 diopters. Peyman, GA. 122(2):284-5., Aug 1996, Am J Ophthalmol. .

Safety and efficacy of laser correction of hypermetropia: early results in a retrospective study comparing VISX Star S4 and SCHWIND Amaris, Presented as poster at XXXII Congress of the ESCRS. Litev M., Mitova D., Mitov T. London,: s.n., 15 September 2014.

Settas, George, Clare Settas, Evangelos Minos, Ian YL Yeung. Photorefractive keratectomy (PRK) versus laser assisted in situ keratomileusis (LASIK) for hyperopia correction. [Online] JUN 13, 2012. [Cited: 11, 2014.]

Manche EE, Haw WW. Prospective Multivariable Analysis of Regression following LASIK for Compound Hyperopic Astigmatism-Phase III US FDA Trial. Investigative Ophthalmology and Visual Science. 2002, 43: E-Abstract 2071.

Boyd, Benjamin F. LASIK and beyond LASIK.

Regression and its mechanisms after laser in situ keratomileusis in moderate and high myopia. Chayet AS, Assil KK, Montes M, Espinosa- Lagana M, Castellanos A, Tsioulias G. 105(7):1194-9., Jul 1998, Ophthalmology.

Regression after LASIK for the treatment of myopia: the role of the corneal epithelium. Lohmann CP, Güell JL. 13(2):79-82, Jun 1998, Seminars in Ophthalmol.

Hjortdal JØ, Møller-Pedersen T, Ivarsen A, Ehlers N. Corneal power, thickness, and stiffness: results of a prospective randomized controlled trial of PRK and LASIK for myopia. J Cataract Refract Surg. 2005 Jan, 31(1):21-9.

Emarah, Mostafa A El-Helw and Ahmed M. Predictability and stability of refraction with increasing optical zone diameter in hyperopic LASIK. Clin Ophthalmol. . 2010, 4: 455–458.

LASEK-нова алтернатива при корекция на смесен астигматизъм, хиперметропия, астигматизъм,. Т. Митов, Г. Филева, М. Милкова. 12 ноември 2007. Новости в офталмологията.

Munnerlyn CR, Arnoldussen ME, Munnerlyn AL, Logan BA. Theory concerning the ablation of corneal tissue with large-area, 193- nm excimer laser beams. J Biomed Opt. July 20, 2005, May 19, 2006 August 22, 2006, December 13, 2006, 11(6):064032.

P., Hughes. Change in corneal asphericity. [Online] [Cited: 02 01, 2015.]

Brancato R, Carones F. Indications, results, and complications of refractive corneal surgery with lasers. Corr Opin Ophthalmlol. 5:90-97, 1994.

AMO, [perf.]. VISX Star excimer laser system - basic science. s.l. : VISX Technology.

Customized ablation profiles. Alio, J. London: ESCRS Annual congres, 2014. Refractive surgery didactic course.

Hollis, Steve. Hollis nomogram for the NIDEK excimer kaser. [Online] [Cited: 08 30, 2015.] for-the-nidek-excimer-laser/.

Rapuano CJ, BS Boxer Wachler, EA Davis, ED Donnenfeld, M. Bowes Hamill, JB Randleman, SI Rosenfeld, D. Tan, WS Clifford. The Basic and Clinical Science Course. Section 13 - Refractive Surgery. s.l. : American Academy of Ophthalmology, 2011.

Femtosecond laser–assisted hyperopic laser in situ keratomileusis with tissue-saving ablation: Analysis of 800 eyes. Leccisotti, ?. 07 2014, Journal of Cataract and Refractive Surgery (Impact Factor: 2.75).

Blum M, Kunert KS, Voßmerbäumer U, Sekundo W. Femtosecond lenticule extraction (ReLEx) for correction of hyperopia - first results.. Graefes Arch Clin Exp Ophthalmol. . 2013 Jan,


Pérez-Escudero, Alfonso, Carlos Dorronsoro, Lucie Sawides, Laura Remón, Jesús Merayo-Lloves, Susana Marcos. Minor In? uence of Myopic Laser In Situ Keratomileusis on the Posterior Corneal Surface. Investigative Ophthalmology and Visual Science. 2009 Sep, 50(9):4146-54.

Баталина, Лариса Владимировна. Клинико-функциональное исследование динамики состояния органа зрения после проведения ЛАСИК примиопии. Москва: н. а., 2002. Ученая степень : кандидат медицинских наук.

Ophthalmology, International Council of. VISUAL ACUITY MEASUREMENT STANDARD. Ste. Margherita Ligure, Italy : s.n., 1984.

Effect of keratometry on visual outcomes 1 month after hyperopic LASIK. Young J., Schallhorn S, Brown, Hettinger. Journal of refractive surgery (Thorofare, N.J.: 1995) (Impact Factor: 2.78). 08/2009; 25(7 Suppl):S672-6.

Personalized treatment with Ray tracing surgery. Cummings, Arthur. European ophth news, s.l. : ESCRS, 09-2014.

Morin, Craig. Characterization and Hydration with the SL-OCT. USA : Graduate school of Ohio State University, 2008. A thesis.

Orbscan pachymetry: implications of a repeated measures and diurnal variation analysis. Lattimore MR Jr1, Kaupp S, Schallhorn S, Lewis R 4th. 106(5):977-81., May 1999, Ophthalmology.

Corneal topography. Roberts, Cynthia. London : ESCRS Annual congress, 2014. Refractive surgery Didactic course.

Manche EE, Maloney RK, Smith RJ. Treatment of topographic central islands following refractive surgery. J Cataract Refract Surg. 24(4):464–470.

Corneal topography. Holladay, Jack. London: ESCRS Annual congress, 2014. Refractive surgery didactic course.

Luger MH, Ewering T, Arba-Mosquera S. In? uence of patient age on high myopic correction in corneal laser refractive surgery. J Cataract Refract Surg. . 2013 Feb, 39(2):204-10.

Ivarsen A, Næser K, Hjortdal J. Laser in situ keratomileusis for high astigmatism in myopic and hyperopic eyes. Journal of Cataract and Refractive Surgery. 2013 Jan, 39(1):74-80.

Igarashi A, Kamiya K, Shimizu K, Komatsu M. Time course of refractive and corneal astigmatism after laser in situ keratomileusis for moderate to high astigmatism. J Cataract Refract Surg. 2012 Aug, 38(8):1408-13 .

CA, Eggink. Refractive Laser Surgery of the Cornea: A Clinical Evaluation. s.l. : SSN Drukkerij, 2000. p. 173. 9090134484,9789090134482.

Бубнова, Ирина Алексеевна. Методы оценки и клиническое значение биомеханических свойств роговицы (клиникоэкспериментальное исследование). Москва н. а., 2011. доктор медицинских наук.



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About The Authors

M. Litev
`Sveta Petka` Varna

L. Voynov
Military Medical Academy Sofia

T. Mitov
`Sveta Petka` Varna

D. Radilov
University of Economics Varna

A. Kalaydjiev
Military Medical Academy Plovdiv