Skip to main content
Transactions of the American Ophthalmological Society logoLink to Transactions of the American Ophthalmological Society
. 2001;99:79–87.

Conductive keratoplasty for the correction of hyperopia.

P A Asbell 1, R K Maloney 1, J Davidorf 1, P Hersh 1, M McDonald 1, E Manche 1; Conductive Keratoplasty Study Group1
PMCID: PMC1359026  PMID: 11797323

Abstract

BACKGROUND/PURPOSE: Conductive keratoplasty (CK) is a surgical technique that delivers radio frequency (350 kHz) current directly into the corneal stroma through a Keratoplasty tip inserted into the peripheral cornea at 8 to 32 treatment points. A full circle of CK spots produces a cinching effect that increases the curvature of the central cornea, thereby decreasing hyperopia. We report here the 12-month results of a 2-year, prospective, multicenter US clinical trial conducted to evaluate the efficacy, safety, and stability of CK. METHODS: A total of 233 patients (401 eyes) with preoperative hyperopia of +0.75 to +3.00 D and < or = 0.75 D of astigmatism (mean preoperative manifest refractive spherical equivalent = +1.76 D +/- 0.60) were enrolled into the study at 13 centers and underwent CK treatment. RESULTS: Twelve-month postoperative data are available on 203 eyes for safety and stability and 171 eyes for safety, stability, and efficacy. A total of 91% had uncorrected visual acuity (UCVA) of 20/40 or better, and 51% had UCVA of 20/20 or better. Manifest refractive spherical equivalent was within +/- 0.50 D in 58%, within +/- 1.00 D in 91%, and within +/- 2.00 D in 99%. The mean change in residual refraction was 0.26 D +/- 0.49 between 3 and 6 months, 0.09 D +/- 0.37 between 6 and 9 months, and 0.13 D +/- 0.39 between 9 and 12 months. CONCLUSIONS: One-year data show safety and efficacy of CK in the treatment of hyperopia. Changes in residual refractive error after CK appeared to be small, suggesting that a stable refraction could be achieved by 6 months.

Full Text

The Full Text of this article is available as a PDF (408.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alió J. L., Ismail M. M., Artola A., Pérez Santonja J. J. Correction of hyperopia induced by photorefractive keratectomy using non-contact Ho:YAG laser thermal keratoplasty. J Refract Surg. 1997 Jan-Feb;13(1):13–16. doi: 10.3928/1081-597X-19970101-06. [DOI] [PubMed] [Google Scholar]
  2. Alió J. L., Ismail M. M., Sanchéz Pego J. L. Correction of hyperopia with non-contact Ho:YAG laser thermal keratoplasty. J Refract Surg. 1997 Jan-Feb;13(1):17–22. doi: 10.3928/1081-597X-19970101-07. [DOI] [PubMed] [Google Scholar]
  3. Argento C. J., Cosentino M. J. Laser in situ keratomileusis for hyperopia. J Cataract Refract Surg. 1998 Aug;24(8):1050–1058. doi: 10.1016/s0886-3350(98)80097-7. [DOI] [PubMed] [Google Scholar]
  4. Bende T., Jean B., Oltrup T. Laser thermal keratoplasty using a continuous wave diode laser. J Refract Surg. 1999 Mar-Apr;15(2):154–158. doi: 10.3928/1081-597X-19990301-13. [DOI] [PubMed] [Google Scholar]
  5. Brinkmann R., Radt B., Flamm C., Kampmeier J., Koop N., Birngruber R. Influence of temperature and time on thermally induced forces in corneal collagen and the effect on laser thermokeratoplasty. J Cataract Refract Surg. 2000 May;26(5):744–754. doi: 10.1016/s0886-3350(00)00310-2. [DOI] [PubMed] [Google Scholar]
  6. Charpentier D. Y., Nguyen-Khoa J. L., Duplessix M., Colin J., Denis P. Thermokératoplastie intrastromale pour la correction de l'hypermétropie sphérique: étude prospective à un an. J Fr Ophtalmol. 1995;18(3):200–206. [PubMed] [Google Scholar]
  7. Dausch D., Klein R., Schröder E. Excimer laser photorefractive keratectomy for hyperopia. Refract Corneal Surg. 1993 Jan-Feb;9(1):20–28. [PubMed] [Google Scholar]
  8. Davidorf J. M., Zaldivar R., Oscherow S. Results and complications of laser in situ keratomileusis by experienced surgeons. J Refract Surg. 1998 Mar-Apr;14(2):114–122. doi: 10.3928/1081-597X-19980301-09. [DOI] [PubMed] [Google Scholar]
  9. Daya S. M., Tappouni F. R., Habib N. E. Photorefractive keratectomy for hyperopia: six months results in 45 eyes. Ophthalmology. 1997 Nov;104(11):1952–1958. doi: 10.1016/s0161-6420(97)30001-3. [DOI] [PubMed] [Google Scholar]
  10. Ditzen K., Huschka H., Pieger S. Laser in situ keratomileusis for hyperopia. J Cataract Refract Surg. 1998 Jan;24(1):42–47. doi: 10.1016/s0886-3350(98)80073-4. [DOI] [PubMed] [Google Scholar]
  11. Durrie D. S., Schumer D. J., Cavanaugh T. B. Holmium:YAG laser thermokeratoplasty for hyperopia. J Refract Corneal Surg. 1994 Mar-Apr;10(2 Suppl):S277–S280. [PubMed] [Google Scholar]
  12. Eggink C. A., Bardak Y., Cuypers M. H., Deutman A. F. Treatment of hyperopia with contact Ho:YAG laser thermal keratoplasty. J Refract Surg. 1999 Jan-Feb;15(1):16–22. doi: 10.3928/1081-597X-19990101-04. [DOI] [PubMed] [Google Scholar]
  13. Eggink C. A., Meurs P., Bardak Y., Deutman A. F. Holmium laser thermal keratoplasty for hyperopia and astigmatism after photorefractive keratectomy. J Refract Surg. 2000 May-Jun;16(3):317–322. doi: 10.3928/1081-597X-20000501-04. [DOI] [PubMed] [Google Scholar]
  14. Esquenazi S., Mendoza A. Two-year follow-up of laser in situ keratomileusis for hyperopia. J Refract Surg. 1999 Nov-Dec;15(6):648–652. doi: 10.3928/1081-597X-19991101-08. [DOI] [PubMed] [Google Scholar]
  15. Geerling G., Koop N., Brinkmann R., Tüngler A., Wirbelauer C., Birngruber R., Laqua H. Continuous-wave diode laser thermokeratoplasty: first clinical experience in blind human eyes. J Cataract Refract Surg. 1999 Jan;25(1):32–40. doi: 10.1016/s0886-3350(99)80008-x. [DOI] [PubMed] [Google Scholar]
  16. Göker S., Er H., Kahvecioglu C. Laser in situ keratomileusis to correct hyperopia from +4.25 to +8.00 diopters. J Refract Surg. 1998 Jan-Feb;14(1):26–30. doi: 10.3928/1081-597X-19980101-07. [DOI] [PubMed] [Google Scholar]
  17. Ismail M. M., Alió J. L., Pérez-Santonja J. J. Noncontact thermokeratoplasty to correct hyperopia induced by laser in situ keratomileusis. J Cataract Refract Surg. 1998 Sep;24(9):1191–1194. doi: 10.1016/s0886-3350(98)80010-2. [DOI] [PubMed] [Google Scholar]
  18. Jackson W. B., Mintsioulis G., Agapitos P. J., Casson E. J. Excimer laser photorefractive keratectomy for low hyperopia: safety and efficacy. J Cataract Refract Surg. 1997 May;23(4):480–487. doi: 10.1016/s0886-3350(97)80203-9. [DOI] [PubMed] [Google Scholar]
  19. Katz J., Tielsch J. M., Sommer A. Prevalence and risk factors for refractive errors in an adult inner city population. Invest Ophthalmol Vis Sci. 1997 Feb;38(2):334–340. [PubMed] [Google Scholar]
  20. Koch D. D., Abarca A., Villarreal R., Menefee R., Kohnen T., Vassiliadis A., Berry M. Hyperopia correction by noncontact holmium:YAG laser thermal keratoplasty. Clinical study with two-year follow-up. Ophthalmology. 1996 May;103(5):731–740. doi: 10.1016/s0161-6420(96)30622-2. [DOI] [PubMed] [Google Scholar]
  21. Koch D. D., Kohnen T., Anderson J. A., Binder P. S., Moore M. N., Menefee R. F., Valderamma G. L., Berry M. J. Histologic changes and wound healing response following 10-pulse noncontact holmium:YAG laser thermal keratoplasty. J Refract Surg. 1996 Jul-Aug;12(5):623–634. doi: 10.3928/1081-597X-19960701-16. [DOI] [PubMed] [Google Scholar]
  22. Koch D. D., Kohnen T., McDonnell P. J., Menefee R. F., Berry M. J. Hyperopia correction by noncontact holmium:YAG laser thermal keratoplasty. United States phase IIA clinical study with a 1-year follow-up. Ophthalmology. 1996 Oct;103(10):1525–1536. [PubMed] [Google Scholar]
  23. Koch D. D., Kohnen T., McDonnell P. J., Menefee R., Berry M. Hyperopia correction by noncontact holmium:YAG laser thermal keratoplasty: U.S. phase IIA clinical study with 2-year follow-up. Ophthalmology. 1997 Nov;104(11):1938–1947. doi: 10.1016/s0161-6420(97)30003-7. [DOI] [PubMed] [Google Scholar]
  24. McDonnell P. J. Radial thermokeratoplasty for hyperopia. I. The need for prompt prospective investigation. Refract Corneal Surg. 1989 Jan-Feb;5(1):50–52. [PubMed] [Google Scholar]
  25. Nano H. D., Muzzin S. Noncontact holmium:YAG laser thermal keratoplasty for hyperopia. J Cataract Refract Surg. 1998 Jun;24(6):751–757. doi: 10.1016/s0886-3350(98)80126-0. [DOI] [PubMed] [Google Scholar]
  26. Neumann A. C., Sanders D., Raanan M., DeLuca M. Hyperopic thermokeratoplasty: clinical evaluation. J Cataract Refract Surg. 1991 Nov;17(6):830–838. doi: 10.1016/s0886-3350(13)80419-1. [DOI] [PubMed] [Google Scholar]
  27. O'Brart D. P., Stephenson C. G., Oliver K., Marshall J. Excimer laser photorefractive keratectomy for the correction of hyperopia using an erodible mask and axicon system. Ophthalmology. 1997 Nov;104(11):1959–1970. doi: 10.1016/s0161-6420(97)30000-1. [DOI] [PubMed] [Google Scholar]
  28. Pietilä J., Mäkinen P., Pajari S., Uusitalo H. Excimer laser photorefractive keratectomy for hyperopia. J Refract Surg. 1997 Sep-Oct;13(6):504–510. doi: 10.3928/1081-597X-19970901-06. [DOI] [PubMed] [Google Scholar]
  29. Pop M. Laser thermal keratoplasty for the treatment of photorefractive keratectomy overcorrections: a 1-year follow-up. Ophthalmology. 1998 May;105(5):926–931. doi: 10.1016/S0161-6420(98)95039-4. [DOI] [PubMed] [Google Scholar]
  30. Rashad K. M. Laser in situ keratomileusis for the correction of hyperopia from +1.25 to +5.00 diopters with the Technolas Keracor 117C laser. J Refract Surg. 2001 Mar-Apr;17(2):113–122. doi: 10.3928/1081-597X-20010301-04. [DOI] [PubMed] [Google Scholar]
  31. Tabbara K. F., El-Sheikh H. F., Islam S. M. Laser in situ keratomileusis for the correction of hyperopia from +0.50 to +11.50 diopters with the Keracor 117C laser. J Refract Surg. 2001 Mar-Apr;17(2):123–128. doi: 10.3928/1081-597X-20010301-05. [DOI] [PubMed] [Google Scholar]
  32. Vinciguerra P., Epstein D., Radice P., Azzolini M. Long-term results of photorefractive keratectomy for hyperopia and hyperopic astigmatism. J Refract Surg. 1998 Apr;14(2 Suppl):S183–S185. doi: 10.3928/1081-597X-19980401-08. [DOI] [PubMed] [Google Scholar]

Articles from Transactions of the American Ophthalmological Society are provided here courtesy of American Ophthalmological Society

RESOURCES