IN MID-DECEMBER 2004, THE U.S. FOOD and Drug Administration approved Visx"s CustomVue system for hyperopia up to 3 D, with astigmatism up to 2 D. As with any new indication, however, there are certain techniques the surgeon has to get used to practicing in order to get the best results. Here is advice from surgeons familiar with performing custom hyperopic corrections using the Visx system.

The Results

Before launching into custom hyperopic techniques, here"s what you can expect from the procedure, based on the FDA trial.
In the trial, researchers presented the results from 136 eyes of 70 custom hyperopic patients to prove the procedure"s effectiveness. The mean patient age was 53, and the average baseline spherical refractive error was +1.7 D (range: 0 to 4.6 D), baseline cylinder was 0.7 D (range: 0 to 2 D), and spherical equivalent was 2 D (range: 0.5 D to 4.8 D).

At six months, in 74 eyes with spherical hyperopia, 97 percent were corrected to 20/40 or better, and 66 percent were corrected to 20/20 or better. In 57 eyes with astigmatic hyperopia, 93 percent saw 20/40 or better and 56 percent saw 20/20 or better. At six months, 65 percent of the hyperopic astigmatic eyes were within 0.5 D of their intended refraction. Ninety-eight percent of the eyes had at most a 1-D change in refraction between three and nine months.