Visual outcome in hypermetropic eye post-refractive surgery: retrospective cohort study

Background: Correction of hypermetropia with laser refractive surgery is considered difficult and challenging compared to myopia, with few studies to make evidence-based decisions. This study assessed visual outcomes and complications in hypermetropic patients after refractive surgery. Methods: This retrospective cohort study included 105 patients with hypermetropia who underwent either laser in situ keratomileusis or photo-refractive keratectomy at a specialized eye center in Jeddah, Kingdom of Saudi Arabia. Multiple preoperative factors were evaluated and compared to 1-month postoperative factors. Results: The patient cohort had a mean age of 38.1 ± 12.0 years, 67 (63.8%) of the patients were female, and laser in situ keratomileusis was performed on 84 (80%) cases. Preoperative central corneal thickness in the right and left eyes was 559 ± 37 and 560 ± 37 ( P = 0.316), respectively. The preoperative and 1-month postoperative uncorrected visual acuity was statistically significantly improved in the right eye, from 0.62 ± 0.32 to 0.91 ± 0.27 ( P = 0.025), and in the left eye, from 0.62 ± 0.31 to 0.89 ± 0.27 ( P = 0.043). The preoperative and postoperative spherical equivalent showed a statistically significant reduction in the right eye from 2.47 ± 1.24 to 0.19 ± 0.96 ( P = 0.001) and in the left eye from 2.64 ± 1.73 to −0.03 ± 1.26 ( P = 0.001). A total of 13 (12.4%) patients had complications, with dry eyes (21.4%) being the most common manifestation. The complication rate was higher in female patients (16.4%) compared to male (5.3%, P = 0.048). Photo-refractive keratectomy had significantly higher complications rated (33.3%) compared to laser in situ keratomileusis (7.1%, P = 0.001). Conclusion: Refractive surgery significantly improved visual outcomes in hypermetropic patients. Dry eye was the predominant complication, with higher rates found in females and patients who underwent photo-refractive keratectomy. Studies with extended follow-up are needed to evaluate the long-term complications and sustained efficacy of refractive surgery in hypermetropic patients.