Accuracy and stability of hyperopic treatments

Abstract

Purpose of review: Treatment of hyperopia presents greater challenges than treatment of myopia for multiple reasons, including the fact that hyperopia tends to progress with age and becomes more symptomatic with the loss of accommodation.

Recent findings: Despite these issues, surgeons have multiple options to treat hyperopia successfully. Modern laser vision correction has high success rates for most patients and performs acceptably in the presence of high hyperopia or high cylinder. Early studies combining excimer laser treatment with collagen cross-linking (CXL) suggest that this may improve refractive stability. Recent studies have also described femtosecond lenticule extraction and use of a solid-state laser in place of the excimer. In addition to cornea-based treatment, long-term studies of a hyperopic phakic intraocular lens have shown excellent visual outcomes and good safety. Cross-linking is increasingly being applied to the hyperopia that follows radial keratotomy.

Summary: The established treatments for hyperopia continue to accumulate evidence supporting their safety and efficacy. The next step forward in treatment may arise from combining these treatments with CXL to stabilize the cornea long-term.