Intended Flap Decentration in Hyperopic Laser in Situ Keratomileusis (Lasik) In Eyes with off-Centered Corneal Apex

Purpose: To evaluate the efficacy of flap decentration during Lasik hyperopic correction in eyes with off-centered corneal apex. Patients and methods: In a prospective study, two groups of patients with hyperopia randomly allocated to undergo Lasik hyperopic correction. In group A (22 eyes); the flap was intentionally decentred during flap creation. In group B (22 eyes) were done without flap decentration. Complete preoperative and postoperative ophthalmic examination was done for all patients with determination of spherical equivalents by cycloplegic refraction, Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA) were also detected. Corneal topography was performed to all patients before and after the operation. Results: The mean UCVA improved from 0.4 ± 0.23 to 0.90 ± 0.21 in Group (A) and from 0.5 ± 0.3 to 0.8 ± 0.2 in Group (B) ( P value = 0.023), and the mean BCVA, from 0.8 ± 0.2 to 0.97 ± 0.1 and from 0.8 ± 0.2 to 0.8 ± 0.2, respectively (P value = 0.01). The mean cycloplegic spherical equivalent improved from + 3.5 ± 0.5 to + 0.25 ± 0.6 in Group (A) and from + 3.8 ± 0.6 to +0.75 ± 0.6 in Group (B) ( P value = 0.02). The safety index was 1.1 in groups and the efficacy index, 1.01 in Group 1 and 0.98 in Group 2. The enhancement rate was 20.0% and 18.4%, respectively. Conclusion: Flap decentration in hyperopic laser correction Keywords: Angle kappa; Topography; Decentered; Hyper-metropi