A cautionary tale of innovation in refractive surgery

Abstract

Hyperopia is difficult to treat surgically. Nearly a dozen techniques strive toward safe, effective outcomes. All techniques are bedeviled by 3 challenges: (1) the need for accurate centration over the pupil of a steeper central optical zone approximately 5 mm in diameter, (2) the potential decreased visual acuity caused by image minification, and (3) the creation of corneal contours with physiologic characteristics able to minimize optical aberrations and regression of initial refractive effect.