Abstract:  Objective To investigate the efficacy of corneal intrastromal lenticule implantation for hyperopia and its influence on higher order corneal aberrations and posterior corneal elevation. Design Retrospective case series. Participants Thirty-one hyperopic eyes of 25 patients who underwent corneal intrastromal lenticule implantation with 18 to 45 years old were enrolled in Jinan Mingshui Eye Hospital from 2020 to 2021. Methods Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), spherical equivalent (SE), anterior segment OCT, and Pentacam corneal topography were performed preoperatively and 1 week, 1 month, 3 months, and 6 months postoperatively. Corneal higher order aberrations (HOA) and posterior corneal elevation from different concentric radial zones were obtained and compared using Pentacam before and after surgery. Main Outcome Measures UDVA, BCDVA, SE, corneal curvature, HOA, posterior corneal surface elevation. Results The UDVA and the BCDVA were significantly improved after surgery (all P<0.001). Six months after surgery, the UDVA of 26 eyes was equal or better than the preoperative BCDVA. The BCDVA of 14 eyes was better than the preoperation. The SE was significantly decreased at each time point after surgery than before surgery (all P<0.001). The SE was (+0.36±0.93) D 6 months after surgery. The anterior surface of corneal curvature increased obviously after surgery, but no change was found in the corneal curvature of posterior surface. The total HOA and spherical aberrations of the whole cornea after surgery (0.98±0.34 μm, -0.13±0.25 μm) were significantly different from those before surgery (0.41±0.09 μm, 0.17±0.11 μm) (all P<0.001). No significant difference was found in the posterior corneal elevationat the corneal apex before and after surgery (P>0.05). The elevation at 1 mm and 2 mm radius reduced significantly at one week (2.76±3.30 μm, -2.29±2.11 μm) compared with baseline (3.86±2.57 μm, -1.63±1.88 μm) (all P<0.05). However, there was no significant difference in posterior corneal elevation before and 6 months after surgery (3.69±3.28 μm, -1.69±1.93 μm) (all P>0.05). Conclusions The 6 months follow-up showed that good visual outcomes were obtained after corneal intrastromal lenticule implantation for hyperopia, no significant refractive regression was observed. Corneal HOA increased after surgery, the elevation of posterior corneal surface decreased first and then returned to the preoperative level. (Ophthalmol CHN, 2022, 31: 435-439)

Key words: hyperopia, corneal intrastromal lenticule implantation, higher order corneal aberrations, posterior surface elevation