The problems of mild and high hyperopia surgical correction are complicated and an individual approach is needed. The aim of the study was to evaluate long-term efficiency and safety of two types of refractive procedures in mild and high hyperopia correction: LASIK and ICL (phakic intraocular posterior chamber contact lens) implantation. The authors evaluated a group of 37 eyes of 20 patients; the average age was 36.3 years +/- 11.8 (SD) and the follow-up period was 28.1 months +/- 10.2 (SD) after LASIK procedure, and a group of 21 eyes of 13 patients; the average age was 28.6 years +/- 6.1 (SD) and the follow-up period 30.4 months +/- 20.9 (SD) after the ICL implantation. They compared occurrence of preoperative, intraoperative and postoperative complications in both methods. They specified the efficiency and safety of the procedure by means of so called efficiency and safety index. With a questionnaire they evaluated the patient's subjective satisfaction with the refractive procedure. In the group of hyperopic LASIK, they proved statistically significant appearance of the refractive error regression, number of performed re-operations, appearance of the peroperative decentration of the photoablation zone and induced astigmatism (p < 0.05). In the ICL group, the repeated preoperative sessions for Nd-YAG laser iridotomies were necessary. Postoperatively, the appearance of keratitis striata, syndrome of the late pigment dispersion, and glare were statistically significant (p < 0.05). The authors also demonstrated higher efficiency and safety of the ICL implantation method comparing to LASIK during the whole follow up period (p < 0.05), and also higher subjective satisfaction after ICL implantation. Comparing the intraocular procedure (ICL) to the laser method (LASIK), in mild and high hyperopia correction, the higher efficiency and safety was achieved by ICL implantation.

Oftalmologicá klinika LF MU a FN Brno pracoviste Bohunice